Key Concepts
Introduction
Preterm labor โ defined as regular uterine contractions with cervical change before 37 weeks gestation โ affects approximately 10% of pregnancies and is the leading cause of neonatal morbidity and mortality worldwide. Tocolytics are medications used to suppress or delay uterine contractions, buying time for antenatal corticosteroids to mature fetal lungs and for maternal transport to a tertiary care center. No tocolytic agent has been proven to improve neonatal outcomes when used beyond 48 hours; the primary goal is a short-term delay of delivery (48โ72 hours) to allow corticosteroid administration. The decision to initiate tocolysis requires careful risk-benefit analysis, as each agent carries significant maternal and fetal risks. Key principle for exams: Tocolytics are NOT used when delivery is safer than continuation of pregnancy (e.g., chorioamnionitis, severe preeclampsia, significant placental abruption, fetal anomalies incompatible with life, or advanced cervical dilation). On the exam, writers often pair stable-sounding options with unstable dataโnotice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar.