The controversy surrounding the use of tocolytic agents has been raging for decades.
The greater ICC values were found in process variables, especially management in spontaneous preterm labor conditions, as corticosteroids use, Group B streptococcus screening, use of tocolytic agents and use of antibiotic.
Use of a tocolytic agent did not appear to increase the morbidity in either of the two groups, and the use of tocolytic agents for the management of peripheral placental hemorrhage may lead to prolongation of gestation period, suggesting the effectiveness of tocolytic agents.
For women with chronic abruption occurring before 34 weeks of gestation in a stable systemic condition, without maternal coagulation disorder or problems on the fetal well-being test, use of tocolytic agents with the objective of prolonging the pregnancy has been confirmed to be a reasonable treatment policy [ 12, 13].
As most randomized trials (RCTs) of tocolytic agents lack power to provide definitive answers, and use delay in delivery as a surrogate endpoint for implied improvements in neonatal outcome related to the administration of steroids, systematic reviews and meta-analyses have been conducted to more adequately study drug efficacy and safety.
The prevalence of pulmonary edema in pregnant women has been reported to be 0.08%, and preeclampsia, congestive heart failure, hyperthyroidism, administration of tocolytic agents, and fluid overload are known to be major causes of pulmonary edema [3, 4].
In such circumstances, prolongation of pregnancy, especially administration of tocolytic agents, could worsen the neonatal prognosis.
These women were also administered two 12-mg doses of betamethasone with a 24-h interval to accelerate fetal lung maturation, and we avoided administration of tocolytic agents.
The choice of tocolytic agent depends mainly on the availability following regulatory approval in the country, the drug efficacy and effectiveness, the foetal and maternal safety profiles, and the costs of treatment.
Additionally, maternal use of NSAIDs as tocolytic agents affects renal development, leading to tubular alterations and low nephron numbers [ 36, 37].
Among these treatments, β2-adrenoceptor (ADRB2) agonists are becoming less used worldwide as tocolytic agents because of important maternal and fetal side effects.
