What are contraindications for tocolytic therapy in the treatment of preterm labor?

Updated: Dec 17, 2018
  • Author: Michael G Ross, MD, MPH; Chief Editor: Carl V Smith, MD  more...
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Answer

Answer

When the LMP is not reliable, the gestational age is determined by the first ultrasonography. Following gestational age determination, assessment of fetal well-being, fetal growth, and evaluation of congenital anomaly should be conducted. Subspecialist consultation (MFM) is recommended in the presence of suspected fetal anomalies because tocolytics are generally contraindicated for any congenital anomaly incompatible with life. Tocolytics are not indicated in patients with either suspected or confirmed IAI. Use of tocolytics is relatively contraindicated when evidence of a hostile intrauterine environment exists, such as the following:

  • Oligohydramnios

  • Nonreactive nonstress test results

  • Positive contraction stress test results

  • Absent or reversed diastolic flow upon Doppler examination of umbilical blood flow

  • Repetitive severe variable decelerations

  • Significant vaginal bleeding consistent with abruption, unless patient is stable and fetal well being established


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