Tocolysis

Tocolytics are medicines given to women in suspected or diagnosed PTL to supress uterine contractions with the aim of delaying birth to improve neonatal outcomes. Comprehensive network meta- analyses have shown tocolytic drugs are effective in delaying delivery by 48 hours and 7 days (79).

It is important to stress that delaying PTB may not always be advan­tageous to the neonate and there can be detrimental effects of keeping a baby in utero in the short term. An overtly septic or inflammatory uterus triggering labour can negatively impact neurodevelopment if the fetus is forced to remain in a ‘hostile' environment.

There is considerable variation in clinical practice with respect to the medicinal class, doses, and subgroup of women who re­ceive tocolysis. Additionally, there are very little data for the use of tocolysis before 25 weeks and uncertainty remains over which should be the drug of choice.