How to Prevent or Stop Preterm Labor

Preterm labor and birth are complicated and challenging issues, even in today's sophisticated medical realm. As many as 12 percent of pregnant women experience labor earlier than is considered safe for their babies. Medical professionals agree that successfully stopping preterm labor is directly related to how quickly women seek out and receive treatment and their babies receive corticosteroid stimulants to develop their lungs more quickly. The best method of maternal treatment, however, is left to the judgment of each woman and her doctor.

In the past, drugs such as terbutaline or ritodrine were used to slow or stop preterm labor contractions, but recently their use has been avoided because of the recently discovered associated maternal and fetal side effects. Current drugs of choice include magnesium sulfate, betamimetic drugs, indomethacin, and nifedipine. Current research shows that if a woman begins having regular contractions between 30 and 34 weeks, nifedipine is the best choice (indomethacin may be more appropriate before 30 weeks gestation).

Nifedipine, known by its brand names Adalat and Procardia, is currently only FDA approved for treating high blood pressure and heart disease, but several randomized studies have shown that its off-label use to stop preterm preterm contractions is more effective, and safer, than its on-label competitors.

Nifedipine is a type of calcium channel blocker, which relaxes the uterine muscles, since muscles need calcium to contract. It is taken orally, and frequently prolongs pregnancy by at least seven days following treatment, and commonly up to 34 weeks gestation, allowing the baby's lungs more time to develop fully.

In comparison to other drugs used to stop preterm labor, Nifedipine is associated with fewer admissions of newborns to the neonatal intensive care unit, a lower incidence of Respiratory Distress Syndrome (RDS),

necrotizing entercolitis, and intraventricular hemorrhage. Overall, Nifedipine has fewer maternal and fetal side effects, is more effective than both magnesium sulfate and betamimetic drugs, and can be used for longer periods of time due to its increased safety over the alternatives. Many doctors are now choosing the calcium channel blocker for this off-label use.

However, a few precautions should be taken when considering whether or not to use Nifedipine to stop preterm labor. Such as the fact that Nifedipine should never be used in combination with magnesium sulfate. Women who have previously given birth, or have liver or heart disease should use caution when accepting this drug, ensuring that their care providers know of any existing health conditions.

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http://www.webmd.com/baby/nifedipine-for-preterm-labor
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Crowther CA, Hiller JE, Doyle LW. Magnesium sulphate for preventing preterm birth in threatened preterm labour. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.:CD001060. DOI:10.1002/14651858.CD001060.