Tocolytics—to slow or stop labor:
1. Calcium channel blockers
2. Betamimetics
3. Nonsteroidal anti-inflammatory drugs (NSAIDs)
4. Magnesium sulfate—may also be given to help with brain growth in the fetus
Antibiotics—to prevent or treat infection in the mother and baby
Progesterone (given vaginally or by injection)—to prevent premature birth
Corticosteroids—to mature the baby's lungs if premature birth happens

Tocolytics

Tocolytics are drugs that ease the strength of contractions and how often they happen. They are given for 48 hours to delay delivery of the baby. This gives the baby more time to grow. Antibiotics and steroids may also be given during this time.

These drugs can be given through an IV or by mouth between 24 and 34 weeks of pregnancy.

Calcium Channel Blockers

Common name: Nifedipine

Calcium channel blockers ease muscle contractions in the womb. They may also help prevent respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and jaundice.

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common names are:

Ibuprofen
Indomethacin
Ketorolac
Sulindac

Prostaglandins cause uterine contractions. NSAIDs block the production of prostaglandin in the body. It may also be in some causes of preterm contractions.

Betamimetics

Common names are:

Terbutaline
Ritodrine

These drugs cause muscles in the womb to relax.

Magnesium Sulfate

This muscle relaxant is given by IV. It may not delay preterm birth, but it does help treat pre-eclampsia and protect against brain injury in the baby.

Antibiotics

Common names are:

Penicillin
Ampicillin
Clindamycin
Vancomycin
Cefazolin

Preterm babies are at higher risk of infection because their immune systems are not fully developed. Antibiotics help treat and prevent infection in the mother and the baby.

Progesterone

Also known as hydroxyprogesterone.

Progesterone is a hormone made by the body. It helps the womb grow and keeps it from having contractions. It may help lower the risk of premature birth in women who are at high risk.

Corticosteroids

Common names are:

Betamethasone
Dexamethasone

Corticosteroids may be given between 24 and 34 weeks of pregnancy. These drugs help the baby’s lungs mature. They also lower the risk of respiratory distress syndrome and bleeding in the brain.

References:

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 171: Management of Preterm Labor. Obstet Gynecol. 2016 Oct;128(4):e155-64, reaffirmed 2018.

Premature labor. American Pregnancy Association website. Available at:
...(Click grey area to select URL)
Accessed August 3, 2020.

Preterm labor. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/preterm-labor. Accessed August 3, 2020.

Preterm labor and birth. The American College of Obstetricians and Gynecologists website. Available at: https://www.acog.org/patient-resources/faqs/labor-delivery-and-postpartum-care/preterm-labor-and-birth. Accessed August 3, 2020.

Preterm labor and birth. National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/preterm/Pages/default.aspx. Accessed August 3, 2020.

Prevention of preterm labor and preterm birth. EBSCO DynaMed website. Available at: https://www.dyname.... Accessed August 3, 2020.

Treatments for preterm labor. March of Dimes website. Available at:
...(Click grey area to select URL)
Accessed August 3, 2020.

What treatments are used to prevent preterm labor and birth? National Institute of Child Health and Human Development website. Available at: https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/Pages/treatments.aspx. Accessed August 3, 2020.

Last reviewed March 2020 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Last Updated: 2/24/2021

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