‘Normal’ pregnancy with adverse events on initial tocolytic treatment

Abstract

Preterm birth is never low risk and there are advantages gained by prolonging gestation even at relatively advanced stages of pregnancy. This means that high-value treatments should not just be reserved for high-risk pregnancies. Some women treated with tocolytics will experience adverse events, and some adverse events are particularly associated with different classes of tocolytic agents. Cardiovascular adverse events are particularly common with beta-agonists and there have been several maternal deaths from pulmonary oedema as a result of beta-agonist use for tocolysis. Calcium channel blockers are often associated with maternal hypotension, and a number of case studies reporting serious adverse events have been reported. The aim of this case study is to discuss what can be done if a patient experiences adverse events with tocolytics, and suggests approaches to continuing patient management and implications for obstetric practice.