Pre-term labour
- Nifedipine is the NICE recommended first-line tocolytic for those in pre-term labour
- Atosiban, an oxytocin receptor antagonist, is second-line
Foetal distress
- β2 receptor agonists, e.g. terbutaline IV or salbutamol, are not recommended for tocolysis in pre-term labour, but are the most commonly used in uterine hyperstimulation
- Up to 10% crosses placenta to cause foetal tachycardia
- May be more effective than magnesium (Cochrane Library, 1998)
- GTN
- Can be used to cause uterine relaxation; it's useful in theatre as it can be rapidly sprayed under the tongue of the awake patient
- Causes more hypotension than the beta-adrenoreceptor agonists
- Magnesium is another option