After GW 34, careful weighing of the benefits and
risks generally leads to the conclusion that prolonging
pregnancy with drugs is not indicated.
Tocolytic therapy should be given for as short a
time as possible and promptly terminated once
contractions have ceased. There is no indication in
routine clinical practice for continuing tocolytic
therapy for more than 48 hours. Tocolysis for more
than 48 hours and after the cessation of contractions
is indicated only in exceptional cases (e.g., placenta
previa hemorrhage, amniotic sac prolapse).
Individualized therapy consists of the selection of
the tocolytic agent that is most effective for each patient,
and that has the least side effects, from among
the agents discussed in the following paragraphs,
which are also listed in Table 2. There is no single
tocolytic agent of first choice.