Which medicine should be taken for premature uterine contractions during pregnancy?
Q: I am a 30 years old female into my eighth month of pregnancy. I have been prescribed tablet Allylestrenol, twice daily by the doctor for premature uterine contractions. My sister-in-law is taking tablet Duvadilan 1/2- 1/2- 1/2 for 5 days for the same problem. Which medicine is better- Allylestrenol or Duvadilan?
A:Duvadilan (isoxsuprine) used to be prescribed for prevention of premature labour till early seventies in western countries like United States. However, there was not adequate evidence about its efficacy and hence the United States Food and Drug Administration (USFDA) directed the manufacturers not to promote its use in this disorder. There was also concern that its use can lead to increased risk of Respiratory Distress Syndrome (RDS) in the foetus. There are several options in the management of premature (preterm) labour such as a progestational hormone (such as allylestrenol sold as Maintane), nifedipine, ritodrine (sold as Yutopar), indomethacin (sold as Indocap). However most of these agents delay the labour by up to 48 hours. Before these agents are used, one can be prescribed a course of a steroid (such as metamethasone or dexamethasone) to improve respiration and prevent RDS in the foetus.