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Preterm Labor & Drugs

Drugs Used in Preterm Labor

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Three kinds of drugs are given to women who are having preterm labor. These drugs:

  • Help slow or stop labor contractions
  • Help the baby's lungs mature
  • Help prevent infection in the mother and baby

Stopping Contractions
The drugs described below reduce or stop contractions. They are given intravenously (IV), by mouth or rectally.

Like other drugs, these medications sometimes have side effects for the mother, the baby, or both. The side effects for the baby may occur in the mother's womb or after birth. The side effects can be upsetting, uncomfortable and even serious. The severity differs from person to person. Before choosing a drug, the health care provider and the woman must weigh the risks and benefits of the various drugs and consider the individual needs of the woman and her baby.

Calcium channel blockers (nifedipine)
Possible side effects for the mother: Redness of the skin, headache, dizziness, nausea, low blood pressure

Possible side effects for the baby: None noted as yet

Prostaglandin synthetase inhibitors (indomethacin, ketorolac, sulindac)
Possible side effects for the mother: Nausea, heartburn

Possible side effects for the baby: Tightening of the blood vessel through which the baby's blood flows from one major blood vessel to another (ductus arteriosus), high blood pressure in the lungs, decrease in kidney function, bleeding within the brain or heart, jaundice (yellowish color of the skin and eyes), decreased blood flow to the bowel resulting in infection (necrotizing enterocolitis)

Magnesium sulfate
Possible side effects for the mother: Redness of the skin, tiredness and drowsiness, headache, muscle weakness, double vision, dry mouth, fluid in the lungs, heart attack

Possible side effects for the baby: Tiredness and drowsiness, decreased muscle tone, slow breathing, loss of minerals

Beta-mimetics (terbutaline, ritodrine)
Possible side effects for the mother: Rapid heartbeat, fluid in the lungs, poor blood flow, low blood pressure, fast heartbeat, high levels of sugar in the blood, high levels of insulin in the blood, low amounts of potassium in the blood, reduced amounts of urine, changes in the function of the thyroid gland, shaking, nervousness, nausea or vomiting, fever, hallucinations

Possible side effects for the baby: Fast heartbeat, high levels of insulin in the blood, low or high levels of sugar in the blood, enlarged heart, poor blood flow, low levels of calcium in the blood, jaundice (yellowish color of the skin and eyes), low blood pressure, bleeding within the brain or heart

Helping the Baby Breathe
When a woman goes into preterm labor, she usually is given a type of steroid drug called a corticosteroid. This drug helps the baby's lungs mature so that he or she can breathe more easily after birth. Steroids reduce breathing problems in newborns and help prevent a serious lung disease called respiratory distress syndrome. Steroids also help prevent bleeding in the baby's brain and a serious bowel disease called necrotizing enterocolitis. The recommended steroid drugs are called dexamethasone and betamethasone.

Preventing Infection
Pregnant women who are having
preterm labor are routinely given antibiotics. These drugs help prevent infection in both the mother and the baby. Premature babies are at increased risk of infection because their immune systems are immature.

The information in this article is based on ACOG Practice Bulletin, number 43 (May 2003), produced by the American College of Obstetricians and Gynecologists.

Information Provided By: Patrick Thornton, CNM of MrMidwife.org & PghBabyTalk.org

 


 
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