Preventing Preterm Birth: The Search for Tocolytic Synergism.

Preterm birth is a common cause of neonatal mortality and morbidity, which are increasingly prevalent today. Preterm birth affects millions of babies worldwide and is the subject of intense study in its pathophysiology and therapy. Tocolytic agents are drugs used to prevent preterm birth and prolong pregnancy, to allow the fetus to remain in utero for further maturation, permit antenatal corticosteroid treatment to accelerate fetal lung maturity, and allow enough time for in utero-transfer of the baby to a tertiary care facility. However, the application of traditional tocolytic therapy is often limited due to maternal and fetal side effects. As such, there is a pressing need for safer and more effective tocolytic therapy. Combinational tocolysis has the potential to improve tocolytic efficacy and reduce side effects. A limited number of papers have revealed the prospective benefits of combinational tocolysis by drug synergism and reduced drug toxicity. This review summarizes the current landscape of combinational tocolysis directed at achieving tocolytic synergism and examines the quantitative methods utilized for detecting synergistic tocolytic combinations.