Drug given to reduce the uterine contraction during preterm labour with least side effect
Progesterone Among the given options progesterone is the drug with the least side effect. - Natural progesterone is completely innocuous for the mother and fetus. - The problem is that, the use of progesterone as tocolytics is controversial. Some studies have proved that progesterone can be used as tocolytics. Progesterone does have a role in prefer'', labour According to American college of obs and Gynae (ACOG) progesterone is given in patients with history of previous preterm labour and in women who are at risk for preterm labour (i.e., women with sho cervix). - In these patients progesterone administration stas from 16th month and is continued up to 36 months progesterone acts by reducing uterine contractions. An impoant point Progesterone reduces or prevents uterine contractions when the uterine contractions are not fully established but once the labour sets in i.e., regular uterine contractions sta progesterone has no role. - Progesterone cannot prevent regular uterine contractions of labour. We are not sure from the question, what they want to ask. The question does not clearly differentiate if they are asking about uterine contractions of pregnancy or labour. Once again remember If labour has begun, progesterone has no use. Among other tocolytics, calcium channel blockers have the least side effects. It is an effective tocolytic that is well tolerated by the majority of the pregnant patient. No significant fetal problems have been repoed after treatment with Nifedipine. The most common side effect seen with Nifedipine is lowering of B.P, facial flushing can be seen in ceain cases. Unlike the [3 adrenergic tocolytics they have no effect on carbohydrate metabolism and can be given to diabetic patient. Beta adrenergic agonists These are usually the tocolytics of choice for the treatment of preterm labour. They also have serious side effects which are Pulmonary edema - It is a serious and common side effect of 13 agonists. - It occurs in patients receiving oral or intravenous treatment. - It is common in patients having chorioamnionitis and in twins. Hyperglycemia - When 13 adrenergic drugs are given to patients with insulin dependent diabetes it causes significant hyperglycemia, glycosuria and ketonuria. - This occurs due to increased glycogenolysis and increased lipolysis. fi adrenergic agents are contraindicated in chorioamnionitis Side effects of magnesium Pulmonary edema Hypothermia Neuromuscular toxicity
Ritodrine
Nifidipine
Magnesium sulphate
Progesterone