Therapeutics Prescribing Safety
RRM Academy Synopsis
Terbutaline for preterm labor was stopped for side effects in 2.7%
A 1985 review of 330 patients given terbutaline to halt preterm labor found that the drug was stopped for side effects in only nine patients, or 2.7%. Outcomes were uniformly good with intact membranes.
Key Findings
- Nine of 330 patients (2.7%) stopped terbutaline because of side effects, mainly maternal tachycardia or vomiting.
- Pulmonary edema was diagnosed in no patient, although two reported chest symptoms.
- With intact membranes, outcomes were uniformly good, especially when the infusion started before the 30th week.
- Half of the patients with intact membranes had labor prolonged for six weeks or more, and most failures involved complications present at admission.
- The records covered a five-year period.
Interpretation
This summary rests on the published abstract alone. The design is a retrospective record review of one treated group. The authors suggest that severe side effects stay uncommon with glucose as the infusion medium and concentrated solutions that avoid fluid overload. They add that patients need close monitoring, with the infusion reduced or stopped at the first signs of serious effects.
RRM Context
Restorative reproductive medicine looks for the underlying causes of preterm birth. This 1985 paper addresses the safety of one medication once preterm labor has begun.
Abstract
The medical records of 330 patients treated with terbutaline infusion for the inhibition of preterm labor were reviewed over a five-year period. In patients with intact membranes the results were uniformly good, particularly when treatment was instituted before the 30th week. Half these patients had a prolonged labor of six weeks or more; in most cases of treatment failure complications already existed on admission. In only nine patients (2.7%) terbutaline treatment was stopped due to side effects: predominantly maternal tachycardia or vomiting. Two patients had chest symptoms, but in no case was pulmonary edema diagnosed. The results suggested that a low incidence of severe side effects can be obtained if the following precautions are taken: glucose is used as the infusion medium, instead of sodium chloride; concentrated solutions are given to avoid fluid overload; the patients are carefully controlled; and the infusion is immediately reduced or stopped if signs of severe side effects appear.
Topics
Keywords
Dose-Response Relationship, Drug, Female, Fetal Membranes, Premature Rupture/drug Therapy, Gestational Age, Humans, Infusions, Parenteral, Nausea/chemically Induced, Obstetric Labor, Premature/prevention & Control, Pregnancy, Pregnancy, Multiple, Pulmonary Edema/chemically Induced, Tachycardia/chemically Induced, Terbutaline/adverse Effects/therapeutic Use, Vomiting/chemically Induced, Terbutaline
