Conclusion

The work described above demonstrates the major advances that have been made in the oxytocin field over the last 15 years. Modification of the natural hormone has led to peptide antagonists suitable for short-term intravenous administration in the acute treatment of preterm labour. One of these molecules, atosiban, has been approved in Europe for this indication. Recently, non-peptidic antagonists with generally improved selectivity for the ox-ytocin receptor over the related vasopressin receptors and improved phar-macokinetic properties, including oral bioavailability, have been discovered. These molecules offer the prospect of much-improved therapeutic options for the distressing condition of preterm labour, which too frequently leads to the birth of very immature babies with very limited life expectancy or with major disabilities. Treatment of the mother in preterm labour with an ox-ytocin antagonist to achieve acute tocolysis and then as maintenance for the critical last trimester of pregnancy may make a major difference to these parents and their offspring.

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