Efficacy of terbutaline in preterm labour - our experience

Authors

  • Priyadarshini Bai G. Department of Pharmacology,Sri Siddhartha Medical College, Tumakuru, Karnataka, India
  • Ravi Kumar P. Department of Pulmonology, Sri Siddhartha Medical College, Tumakuru, Karnataka, India
  • T. N. Kumar Department of Pharmacology,Sri Siddhartha Medical College, Tumakuru, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20163247

Keywords:

Preterm labour, Terbutaline, Tocolytic, Efficacy, Safety, Gestational

Abstract

Background: Preterm birth is one of the important causes of perinatal mortality and morbidity in developed countries after congenital malformations. Postponement of delivery plays essential role in preventing such incidences by allowing fetal lung maturity.

Methods: This is a prospective study conducted over a period of 20 months among the patients admitted for preterm labour with gestational period between 27 to 36 weeks. After the patients obeyed all the inclusion criteria, they were administered terbutaline 250 µg subcutaneously every 8th hourly followed by 5 mg tablet orally twice daily till contractions ceased. The patients were analysed for gestational period at which they presented with preterm labour contractions, associated risk factors, response to terbutaline, and gestational period at delivery, perinatal complications, neonatal and maternal outcomes. The data obtained were analysed by descriptive analysis.

Results: There were 1,678 deliveries during study period, out of which 207 (12%) presented with preterm labour and 20 (~10%) patients received terbutaline. Idiopathic (50%) and vaginal infections (25%) were common causes of preterm labour among the patients who received terbutaline. The labour was prolonged by 3 - 5 days among 8 patients, 7 - 15 days in 9 patients and 15 - 30 days in 3 patients. Common maternal side effects were nausea and tremors. Neonatal outcome was good in most of the cases except in 5 (25%) neonates who required NICU admission but they all recovered well without any morbidity.

Conclusions: Administration of terbutaline prolonged labour without any serious maternal complications and better neonatal outcome as 90% of the neonates were born without any complications. Hence, terbutaline can be used as a safe and effective tocolytic agent among patients presenting with preterm labour.

References

World Health Organization: Recommendations of the WHO consultation of methodology of reporting and analysis of perinatal and maternal morbidity and mortality. Bristol; 1972.

Steer P. The epidemiology of preterm labor. BJOG. 2005;112(1):1-3.

Houtzager BA, Hogendoorn SM, Papatsonis DN, Samsom JF, van Geijn HP, Bleker OP, et al. Long term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labor. BJOG. 2006;113:324-31.

Uma S, Nisha S, Shikha S. A prospective analysis of etiology and outcome of preterm labor. J Obstet Gynaecol India. 2007;57(1):48-52.

Crowley P. Prophylactic corticosteroids for preterm birth (Cochrane Review). Cochrane Database Syst Rev. 2000;(2):CD000065.

Keirse M. The history of tocolysis. BJOG. 2003;110(20):94-7.

Clinical green top guidelines: tocolytic drugs for women in preterm labour (1B) London UK. RCOG; 2002.

Groome LJ, Goldenberg RL, Cliver SP, Davis RO, Copper RL. Neonatal periventricular-intra-ventricular hemorrhage after maternal beta-sympathominmetic tocolysis: The march of dimes multicenter study group. Am J Obstet Gynecol. 1992;167:873-9.

Treatment of preterm labor with the beta-adrenergic antagonist ritodrine: The Canadian preterm labor investigators group. N Engl J Med. 1992;327:308-12.

Gyetvai K, Hannah ME, Hodnett ED, Ohlsson A. Tocolytics for preterm labor: a systematic review. Obstet Gynecol. 1999;94:869-77.

Rodts-Palenik S, Morrison JC. Tocolysis: an update for the practitioner. Obstet Gynecol Surv. 2002;57:S9-34.

Mawaldi L, Duminy P, Tamim H. Terbutaline versus nifedipine for prolongation of pregnancy in patients with preterm labor. Int J Gynaecol Obstet. 2008;100:65-8.

Collaris R, Tan PC. Oral nifepidine versus subcutaneous terbutaline tocolysis for external cephalic version: a double-blind randomised trial. BJOG. 2009;116:74-80.

Mohamed Ismail NA, Ibrahim M, Mohd Naim N, Mahdy ZA, Jamil MA, Mohd Razi ZR. Nifedipine versus terbutaline for tocolysis in external cephalic version. Int J Gynaecol Obstet. 2008;102:263-6.

Phupong V, Charakorn C, Charoenvidhya D. Oral salbutamol for treatment of preterm labor. J Med Assoc Thai. 2004;87:1012-6.

Trabelsi K, Hadj Taib H, Amouri H, Abdennadheur W, Ben Amar H, Kallel W, et al. Nicardipine versus salbutamol in the treatment of premature labor: Comparison of their efficacy and side effects. Tunis Med. 2008;86:43-8.

Vani S, Lau SY, Lim BK, Omar SZ, Tan PC. Intravenous salbutamol for external cephalic version. Int J Gynaecol Obstet. 2009;104:28-31.

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Published

2017-01-10

How to Cite

G., P. B., P., R. K., & Kumar, T. N. (2017). Efficacy of terbutaline in preterm labour - our experience. International Journal of Basic & Clinical Pharmacology, 5(5), 2118–2122. https://doi.org/10.18203/2319-2003.ijbcp20163247

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Original Research Articles