Modern possibilities and prospects of tocolytic therapy

Abstract

The urgency of the problem of preterm birth (PB) is due to the high prevalence and neonatal mortality. The effects of PB on the fetus are often fatal: PB accounts for 70% of neonatal mortality and 36% of infant mortality. Severe neurological deficits (cerebral palsy, epilepsy, intraventricular hemorrhages, retinopathy, blindness, hearing loss, delayed neuropsychiatric and motor development) are present in 68% of surviving premature infants. In addition, children born prematurely have a high risk of purulent septic diseases. The metabolic consequences of prematurity form the prerequisites for the development of diseases such as metabolic syndrome and hypertension. In this regard, tocolytic therapy is a very important and relevant therapeutic measure in obstetrics. However, most of the known and actively used tocolytic drugs have insufficient effect for long-term prolongation of pregnancy or are associated with serious side effects. Currently, there is an active search for new tocolytics in order to obtain the safest, most powerful and long-term effect. This review article examines the most promising and relevant drugs that have a good chance of entering routine obstetric practice.Materials and methods:Scientific papers, meta-analyses, and systematic reviews were analyzed, which are publicly available in the databases PubMed, Embase, Web of Science and Google Scholar, Science Index. For the analysis, publications published in English and posted no more than 5 years ago were mainly selected, with the exception of fundamental works with a longer publication period.