Life after Ipradol

Abstract

Preterm birth continues to be a global public health burden. Most neonatal deaths occur as a result of prematurity, and among those who survive, a substantial proportion develop disability during childhood. Preterm birth usually follows spontaneous preterm labour, preterm prelabour rupture of membranes, or iatrogenic preterm delivery. Short-term tocolysis is generally indicated to arrest labour in order for corticosteroids to be given, or for the woman to be transferred to a higher level of neonatal care. Hexoprenaline was the cornerstone of such therapy in South Africa for many years. A wide variety of tocolytic drugs have been in clinical use around the world, yet the evidence that they confer benefit to the infant remains open to debate. Some tocolytic drugs may possibly be harmful. In this review the evidence for efficacy and safety of the various commonly used tocolytic drugs will be scrutinized, in particular their effect on infant health and maternal safety. Data on newer agents will also be reviewed, and future directions for tocolytic therapy will be explored.

Keywords: Hexoprenaline; Pregnancy; Preterm labour; Tocolysis