[Tocolysis for preterm labor with intact membranes].

Tocolysis is a tte gold standard in France in preterm labor before 34 WG. Nifedpine and atosiban are recommanded as first line tocolysis since the clinical guidelines published in 2016 by the French College of Obstetrics and Gynecology (CNGOF). Pregnancy prolongation over 48hours due to tocolysis has been demonstrated in several studies, without impact on prematurity. These 48hours allow antenatal corticotherapy and in utero transfer. Despite these promising results, no study had been able to demonstrate any improvement in neonatal prognosis or in infants until 5,5 years old due to tocolysis, questioning the current place of tocolysis in preterm labor. Nevertheless, datas are weak due to the lack of power of all studies in the last 20 years to demonstrate any change in neonatal prognosis. Therefore, it is still difficult to identify populations to exclude from tocolysis. Beyond medication, other parameters need to be considered such as national and territorial health organization, specific to each country. A collegial opinion with a revision of the national guidelines including all the parameters is necessary before any change in preterm labor management.