Terbutaline for Slowing Preterm Labor
Examples
Terbutaline is sometimes used as
a tocolytic medicine to slow uterine contractions
during
preterm labor.
The use of terbutaline for the treatment of preterm labor is an
unlabeled use of the medicine. Terbutaline has been
approved by the U.S. Food and Drug Administration (FDA) for the treatment of
asthma and other breathing conditions, but it is also widely used to treat
preterm labor.
Terbutaline should not be used for longer than 72 hours for the treatment of preterm labor.
How It Works
Terbutaline can relax
smooth muscles, like the uterus. It also affects the smooth muscles
of the blood vessels and the small airways of the lungs.
Why It Is Used
Terbutaline can be used
during preterm labor when:
- Labor needs to be delayed for 24 to 48 hours
to:
- Let
corticosteroids, given to the mother, help fetal lungs
mature.
- Provide time to move a mother to a hospital that provides
neonatal intensive care, if her local hospital does not.
- Regular uterine contractions have thinned
(effaced) the
cervix less than 80% and opened (dilated) it less than
4 cm, and the mother's amniotic sac has not broken.
- The mother is
healthy.
- The fetus is alive and not in distress.
Depending on the medical facility, terbutaline
may be the first medicine used to delay premature birth.
How Well It Works
Terbutaline can be effective when labor needs to be delayed for 24 to 48 hours.
But the medicine usually does not completely stop contractions. Nor has it been shown
to lower risks for the premature baby.1, 2
Side Effects
Side effects are common with terbutaline use and may affect both the mother and fetus.
Common side effects of this medicine include:
- Rapid heartbeat or palpitations.
- Headache and dizziness.
- Nausea, vomiting, and diarrhea.
- Anxiety.
- Nervousness or tremor (such as unsteady, shaky hands).
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
If terbutaline
treatment is effective, its effect typically lasts no more than 48 hours.
Long-term treatment is not advised (based on the risk of serious side effects),
nor is it effective.1
- The risks of treatment with terbutaline must be weighed against the
benefit of delaying birth.
- Terbutaline can greatly increase the
mother's and fetus's pulse. The mother must have her blood pressure and pulse
checked frequently during the first few hours of treatment.
Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.
References
Citations
- Cunningham FG, et al., eds. (2010). Preterm birth. In
Williams Obstetrics, 23rd ed., pp. 804–831. New York:
McGraw-Hill.
- Haas DM (2010). Preterm birth, search date June 2009.
Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
Other Works Consulted
- U.S. Food and Drug Administration (2011). FDA Drug Safety Communication: New warnings against use of terbutaline to treat preterm labor. Available online: http://www.fda.gov/Drugs/DrugSafety/ucm243539.htm.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | William Gilbert, MD - Maternal and Fetal Medicine |
|---|
| Last Revised | January 10, 2011 |
|---|
Last Revised:
January 10, 2011
Cunningham FG, et al., eds. (2010). Preterm birth. In
Williams Obstetrics, 23rd ed., pp. 804–831. New York:
McGraw-Hill.
Haas DM (2010). Preterm birth, search date June 2009.
Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
