Therapeutic target
The goal is to prevent harm to the baby by taking appropriate measures.
Therapy recommendations
- Pharmacotherapeutic options are available only for acute placental insufficiency when induced by labor. The procedure is called intrauterine resuscitation or emergency tocolysis.
- For emergency tocolysis are used:
- Betamimetics (synonyms: β2-sympathomimetics, ß2-sympathomimetics, β2-adrenoceptor agonists, beta-stimulators).
- Nitrates (nitro compounds)
- Oxytocin antagonists (oxytocin receptor antagonists).
- Drug therapy for chronic placental insufficiency is not possible. Options for therapy are conservative: bed rest, surgical: delivery. See under “Further therapy“.
Drug groups
Mechanisms of action, of the substances used for tocolysis or emergency tocolysis (intrauterine resuscitation):
- Betamimetics (synonyms: β2-sympathomimetics, ß2-sypathicomimetics, also β2-adrenoceptor agonists, beta-stimulators): They bind to the membrane-bound beta-2 receptors. This beta-stimulation leads to an increase in cyclic adenosine monophosphate (cAMP) via the enzyme adenyl cyclase. Via inhibition of myosin kinase, relaxation of smooth muscle cells in the body and uterine muscles (uterine muscles) occurs.
- Nitrates (nitro compounds): they activate guanosine monophosphate, which, similar to adenosine monophosphate via inhibition of myosin kinase, leads to the relaxation (relaxation) of smooth muscle cells in the body and uterine relaxation (uterine relaxation).
- Oxytocin receptor antagonists (oxytocin antagonists): oxytocin-induced increase in intracellular calcium concentration is inhibited by blocking calcium channels. Intracellular stores become empty, resulting in uterine relaxation.
