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Uterine muscle relaxant drugs for threatened miscarriageLede RL, Duley L
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SummaryUterine muscle relaxant drugs for threatened miscarriageNot enough evidence to say if drugs that relax the muscles of the uterus can prevent threatened miscarriage. Miscarriage is the loss of a baby in the very early weeks of pregnancy (before 20 weeks), before the baby would be able to survive on its own. This can be a devastating loss to expectant parents. Threatened miscarriage is when there is vaginal bleeding, and sometimes pain, but when the cervix remains closed. The review of studies found just one small trial on uterine relaxant drugs to prevent miscarriage, but the study provided insufficient data to be able to assess its effect adequately. More research is needed.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
July 20. 2005 AbstractBackgroundMiscarriage is the spontaneous loss of a pregnancy before the fetus is viable. Uterine muscle relaxant drugs have been used for women at risk of miscarriage in the belief they relax uterine muscle, and hence reduce the risk of miscarriage. ObjectivesTo assess the effects for the woman and her baby of uterine muscle relaxant drugs when used for threatened miscarriage. Search strategyWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (10 September 2009). Selection criteriaRandomised trials were included, and quasi-randomised trials were excluded. The participants were women with a pregnancy of less than 20 weeks' gestation having a threatened miscarriage. The interventions were any uterine muscle relaxing drugs (including tocolytic and antispasmodic agents) compared with either placebo or no drug. Primary outcomes for the review were miscarriage: defined as spontaneous pregnancy loss before fetal viability, baby death (stillbirth or neonatal death) and maternal death. Data collection and analysisBoth review authors independently assessed studies for eligibility and trial quality, and extracted data. Main resultsOne poor quality trial (170 women) was included. This compared a beta-agonist with placebo. There was a lower risk of intrauterine death associated with the use of a beta-agonist (relative risk (RR) 0.25, 95% confidence interval (CI) 0.12 to 0.51). Preterm birth was the only other outcome reported (RR 1.67, 95% CI 0.63 to 4.38). Authors' conclusionsThere is insufficient evidence to support the use of uterine muscle relaxant drugs for women with threatened miscarriage. Any such use should be restricted to the context of randomised trials. |