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| | Clinical Issues and Statistics |
 | | Thirteen percent of patients on subcutaneous terbutaline infusion therapy failed tocolytic therapy or had ruptured membranes, compared with 38 percent on oral therapy. | | | Only 13 percent of patients on subcutaneous terbutaline infusion therapy failed tocolytic therapy or had ruptured membranes, compared with 38 percent on oral therapy. | | | Because the off-label use of drugs is common among physicians when scientific studies and clinical trails support such use, we undertook a systematic review of the literature for supportive evidence for the safety and efficacy of terbutaline for tocolysis. |
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http://www.sidelines.org/clinical.htm
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| | OBLink Preterm Labor Resource - On-Trac Issue 4: SATURDAY 29TH JUNE |
| | Although the vast majority of the audience were in agreement regarding the value of tocolysis, the debate showed how far tocolytic therapy had come and also gave a glimpse into the future needs of mothers and their babies. | | | · Session 5: Tocolytic therapy and clinical experience | | | Professor Fisk explained that difficulties conducting tocolytic trials such as high placebo response (due to false preterm labour), the need for alternative tocolytics for ethical reasons, and women already experiencing tocolysis during transfer to NICU, would contribute to the failure to note any meaningful differences. |
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http://www.oblink.com/display.asp?page=ON-TRAC_issue4_sat-29-june
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| | JRM Feature Article |
| | This investigation was performed to examine the association between prelabor uterine contraction frequency and the success of tocolytic therapy for an acute episode of preterm uterine contractions. | | | In another study, using daily home uterine activity monitoring, the initiation of beta-adrenergic tocolytic therapy was accompanied by a 50% decrease in the proportion of time occupied by low-amplitude, high-frequency contractions among 34 women experiencing preterm labor. | | | The investigation is notable primarily for the apparent absence of a relationship between baseline uterine contraction frequency, preterm labor and tocolytic therapy success. |
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http://www.jreprodmed.com/Features/2003/2003nov.htm
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| | eMedicine - Preterm Labor : Article by Edward R Newton, MD |
| | Future tocolytic therapy may be directed at modifying fetal response. | | | Preconceptual counseling may also be critical in the decision of the patient to get pregnant and in managing her pregnancy once a pregnancy has been identified. | | | Preterm labor and birth are associated with stressful life situations (eg, domestic violence; close family death; insecurity over food, home, or partner) either indirectly by associated risk behaviors or directly by mechanisms not completely understood. |
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http://www.emedicine.com/med/topic3245.htm
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| | Letter - Terbutaline |
| | Based on information available to the Agency, as well as a review of the published literature, it is clear that the demonstrated value of tocolytics in general is limited to an initial, brief period of treatment, probably no more than 48-72 hours. | | | FDA is investigating the promotional activities of companies providing tocolytic therapy services. | | | Further, the bulletin states, "To date, no studies have convincingly demonstrated an improvement in survival or any index of long-term neonatal outcome with the use of tocolytic therapy. |
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http://www.fda.gov/MEDWATCH/safety/1997/terbut.htm
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| | Atosiban |
| | A total of 246 patients were randomized to receive atosiban and 246 to placebo; the primary endpoint was the time from the start of study drug to delivery or therapeutic failure. | | | Eleven articles of preclinical topics and eight clinical studies were analyzed; four of them are randomized placebo controlled trials. | | | Atosiban compared to placebo did not reduce the number of births occurring before 37 weeks, as had happen before with other tocolytic drugs. |
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http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijgo/vol2n1/atosiban.xml
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| | Research Activities, October 2003: Women's Health: Use of tocolytic therapy to stop uterine contractions can prolong ... |
| | The researchers performed a meta-analysis on 16 studies of first-line tocolytic therapy and 8 studies of maintenance therapy to evaluate evidence on the benefits and harms of five classes of tocolytic therapy for treating uterine contractions related to preterm labor: beta-mimetics, calcium channel blockers, magnesium, nonsteroidal antiinflammatory agents, and ethanol. | | | Maintenance tocolytics (poor strength of evidence) showed no improvements in birth or infant outcomes relative to placebo. | | | Tocolytic drugs are typically used to stop uterine contractions during an episode of preterm labor (first-line therapy) or to maintain uterine quiescence after an acute episode (maintenance therapy). |
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http://www.ahcpr.gov/research/oct03/1003RA11.htm
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| | Point/Counterpoint 3-20-00 |
| | Meanwhile, we need to conduct more studies to properly assess its tocolytic effectiveness, while evaluating long-term maternal, fetal, and infant outcomes. | | | In fact, the only randomized clinical trial comparing MgSO4 to saline control for the treatment of preterm labor failed to document any measure of tocolytic effectiveness. | | | So there is a use for the drug. |
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http://www.physiciansweekly.com/archive/00/03_20_00/pc.html
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| | External cephalic version at term: is a tocolytic necessary? -- Robertson et al. 70 (6): 896 -- Obstetrics & Gynecology |
| | The nine patients with unsuccessful version attempts in the group without a tocolytic then received intravenous ritodrine and underwent a second attempt. | | | In our patient population, use of a tocolytic did not significantly increase the probability of a successful version. | | | Twenty of the 30 patients (66.7%) in the tocolytic group and 19 of the 28 patients (67.8%) in the no-tocolytic group had successful versions, a nonsignificant difference. |
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http://www.greenjournal.org/cgi/content/abstract/70/6/896
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| | A Prospective Comparison of Nifedipine and Isoxsupine For Tocolysic |
| | When one considers that the potentially fatal cordiorespiratory complications seen with b sympathomimetic therapy are often preceded by side effect such as tachycardia, dyspnoea, and chest pain. | | | Although both group patients experienced hypotension, it was very significant (average 10 mm Hg diastolic) in isoxsuprine group. | | | The tocolytic drugs most frequently used in India are the b-sympathomimetic agents usually isoxsuprine. |
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http://www.bhj.org/journal/1999_4102_apr99/original_259.htm
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| | Medicolegal Consult |
| | EXPERT COMMENTARY: Controversy concerning the use and choice of tocolytic drugs has raged for nearly 3 decades. | | | Papatsonis et al have performed a randomized clinical trial comparing important neonatal outcomes in randomly assigned ritodrine and nifedipine treatment groups. | | | Because the practical interval from treatment to delivery deliberately may be brief to allow antenatal administration of maternal corticosteroids, potential neonatal risks from drug exposure should influence tocolytic choice. |
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http://www.obgmanagement.com/examin_evidence.asp?which_issue=9/1/00
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| | Reproductive Control Agents: Tocolytic Agents |
| | covers the use of tocolytic drugs, choice of tocolytic drugs, threatened preterm labour, and maintenance. | | | Tocolytic Therapy Prolongs Pregnancy in Preterm Labor Patients.(Brief Article) : An article from: Family Practice News [HTML] | | | Ontogenesis of beta-adrenoceptor signaling: implications for perinatal physiology and for fetal effects of tocolytic drugs. |
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http://zmed.org/D07/D07.825
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| | Tocolytic medication |
| | Tocolytics can also be used to relax the uterine muscles before trying to turn a breech fetus to the head-down position (external cephalic version). | | | Tocolytics are medications used to slow uterine contractions. | | | Examples of tocolytics include ritodrine, terbutaline, magnesium sulfate, nifedipine, and indomethacin. |
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http://www.universityhealth.org/116694.cfm
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| | Management of Preterm Labor: File Inventory |
| | Categories of maternal and fetal/newborn harms related to tocolytic treatment; Quality Control, Adjudication, and Reliability; Quality Rating Development and Analysis; Development of the Evidence Tables; Peer Review Process; Table 11. | | | Studies of the effects of tocolytics as maintenance therapies; Table 16. | | | Meta-analysis results: Effect of first-line tocolytics on the odds of delivery at term (at or beyond 36 to 38 weeks gestation), by tocolytic class; Table 15. |
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http://www.ahcpr.gov/clinic/prtrminv.htm
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| | OBGYN.net - OBGYN.net Journal Review: Is tocolytic magnesium sulphate associated with increased total paediatric ... |
| | All future trials involving obstetric use of MgSO4 should collect data on neonatal outcome. | | | MgSO4 was introduced as a tocolytic in the USA in 1969 on the basis of laboratory work only. | | | In the tocolytic arms, women in preterm labour at less than 34 weeks' gestation and 4 cm dilated or less were randomised to either MgSO4 (4 g bolus, then 2-3 g/hour infusion) or other tocolytic (unblinded obstetrician's choice of ritodrine, terbutaline, indomethacin, or nifedipine). |
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http://www.obgyn.net/displayarticle.asp?page=/jr/review16
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| | Considerations for taking tocolytic medications, Eastern Carolina |
| | Tocolytic medications may help prevent contractions from starting. | | | If you have high blood pressure, or heart or kidney problems, tocolytic medications may be dangerous. | | | Among the factors your doctor or midwife will consider before beginning tocolytic treatment are: |
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http://www.uhseast.com/172391.cfm
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| | Tocolytic - Wikipedia, the free encyclopedia |
| | Tocolytics are medications used to suppress premature labor ( toco refers to contractions, and lytic to removal). | | | They are nearly always given in midpregnancy, when delivery would result in an extremely premature infant. |
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http://en.wikipedia.org/wiki/Tocolytic_agent
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| | Agent, Tocolytic - Talk Medical |
| | Talk Medical > Medical Dictionary > Agent, Tocolytic | | | Agent, tocolytic: A medication that can inhibit labor, slow down or halt the contractions of the uterus. | | | Tocolytic agents are widely used today to treat premature labor and permit pregnancy to proceed and so let the fetus gain in size and maturity before being born. |
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http://www.talkmedical.com/medical-dictionary/413/Agent-Tocolytic
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| | NPEU - Publications |
| | A national survey of women's views of maternity care. | | | 869 Mahomed K, Garner P, Duley L. Tocolytic magnesium sulphate and paediatric mortality. |
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http://www.npeu.ox.ac.uk/publications
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