RISKS AND COMPLICATIONS OF TOCOLYSIS

In this article, the author has reviewed available information on maternal, fetal, and neonatal risks and complications of tocolytic therapy. Because no ideal tocolytic agent exists, clinicians must be aware of the potential problems that can be encountered from initiating tocolysis. A variety of tocolytic agents may be effective in delaying preterm delivery. However, whether these agents reduce perinatal morbidity and mortality is debatable. This review emphasizes that serious complications occur from the use of these drugs including maternal, fetal, and neonatal death. Clinicians who use tocolysis, even oral terbutaline, must be aware of the significant side effects associated with these agents. Caution should be exercised not only in their initiation but also in their continuation. Additional research is needed and ongoing to limit the use of tocolytic agents and develop drugs with more efficacy, less risk, fewer complications, and more tolerable means of administration.