National guidelines in Kenya propose Salbutamol as the tokolytic of choice in case of preterm labour. Therefore Salbutamol at the dose of 4 mg TDS is our first line treatment for the above condition.
Sometimes pregnant mothers experience side effects from the beta2 agonists, above all palpitations.
Nifedipine can be used for preterm labour instead of Salbutamol.
It has fewer side-effects than beta2 agonists.
Nifedipine, for the above indication, can be given as follows:
- 20 mg stat
- then 10-20 mg TDS or QID, adjusted according to uterine activity.
Remember that Nifedipine doesn’t lower a normal BP. So there are no risks of hypotension.
There are some indications in literature also suggesting the use of Indometacin for the same indication, but we prefer not to prescribe it in Chaaria for concerns about neonatal complications such as transient impairment of renal function and premature closure of ductus arteriosus.
Dr Br Giuseppe Gaido
Sources
1) BNF. British National Formulary. March 2010
2) Republic of Kenya. CLINICAL MANAGEMENT AND REFERRAL GUIDELINES
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