Oxytocin receptor antagonists
Term labour and PTL are associated with an upregulation of oxytocin receptors in the myometrium. Atosiban is both an oxytocin receptor and a vasopressin receptor antagonist. Unlike other tocolytics it is administered with a bolus injection followed by an intravenous infusion and as a result it is the most expensive tocolytic available.
It has a favourable side effect profile with nausea the only statistically significant side effect reported when compared to placebo (OR 2.28; 95% CI 1.26-4.13) (80). Unlike calcium channel blockers, it can be given to hypotensive patients. However, the most recent and largest randomized trial to directly compare atosiban (n = 256) and nifedipine (n = 249) found similar rates of adverse perinatal outcomes in babies born to women with threatened PTB (81).
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More on the topic Oxytocin receptor antagonists:
- Changes in uterine physiology
- Arulkumaran S., Ledger W., Denny L., Doumouchtsis S. (eds.). Oxford Textbook of Obstetrics and Gynaecology. Oxford University Press,2020. — 928 p., 2020
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