Terbuatline or Brethine for Preterm Labor

[Birthkeeper]

Terbutaline, a well known drug within the realm of pregnancy and childbirth, has been used for some time to "stop" pre term labor. Women are told that if their contractions come before 36 weeks and are more than 5 in an hour, that they need to head to their local Labor and Delivery Ward. They are then monitored and if contractions are registered, a dose of Terbutaline or Brethine ( generic form ) is administered, usually no questions asked by the patient. The woman is monitored for an additional length of time, and another dose is administered if the contractions do not decrease or stop.

 

However, most ( if any ) women are not told that Terbutaline is NOT approved by the FDA for use in pregnancy or labor, and specifically states that it is not to be used for Tocolysis ( delaying or inhibition of labor ). This is from an official FDA site regarding the use of Terbutaline for Tocolysis:

 

 

Terbutaline sulfate has not been approved and should not be used for tocolysis. Serious adverse reactions may occur after administration of Terbutaline sulfate to women in labor. In the mother, these include increased heart rate, transient hyperglycemia, hypokalemia, cardiac arrhythmias, pulmonary edema, and myocardial ischemia. Increased fetal heart rate and neonatal hypoglycemia may occur as a result of maternal administration. There are no adequate and well-controlled studies in pregnant women.

 

 

And are these women given a handout with the risks and possible side effects of Terbutaline? In addition to the risks cited above, Terbutaline carries these possible side effects:

 

 

Terbutaline sulfate, like all sympathomimetic amines, should be used with caution in patients with cardiovascular disorders, especially coronary insufficiency, cardiac arrhythmias, and hypertension. There have been rare reports of seizures in patients receiving Terbutaline; seizures did not recur in these patients after the drug was discontinued.

 

 

The, the final piece of questionable evidence: Does Terbutaline or Brethine actually *stop* TRUE Pre Term Labor?

 

Studies have shown that Terbutaline is NOT effective for stopping *true* premature labor. ( Contractions that continue to get closer, longer, more intense AND is accompanied by progressive cervical change. )

 

 Placebo vs. Terbutaline Pump, No Difference in Outcomes

 

Data Shows No Support for Use of Terbutaline to Prevent Preterm Labor 

 

Poor Effectiveness and Unknown Risks Associated with Terbutaline 

 

Many of the women that I have spoken with throughout the years, have received Terbutaline for symptoms that aren't even in line with the very definition of TRUE preterm labor. Sure, they may have had more than 5 contractions in an hour, but if they do not become more frequent, become longer in duration, become more difficult to handle AND is not accompanied by PROGRESSIVE CERVICAL CHANGE, then they are *not* experiencing TRUE preterm labor. And the bottom line is that Terbutaline/Brethine have been shown time and time again to NOT be effective, and to introduce risks and side effects.  

[happySAHMmomof2]

May. 12, 2008 at 5:44 PM My doula (now good friend) had a client recently pregnant with twins.  She called her doc office at 26 weeks because of "contractions".  They prescribed her the Terbutaline over the phone without seeing her and told her to take it at home.  She was never seen, never checked for cervical change, nothing.   Kelly (doula) was astonished and talked to her about it.  I don' t believe she ended up taking it and the contractions never progressed.  I was just shocked at the reckless prescribing of something harmful to a woman who was not even seen by the doctor.  I also thought if it was a real case of PTL she should have been given magnesium. 

[ColleenF30]

May. 12, 2008 at 6:27 PM A friend of mine was just given this a few weeks ago as she was entering her 36th week.  I didn't realize the risks involved.  I will be sending this info to her.  Thanks!!!!

[dreyamom]

May. 14, 2008 at 12:41 AM I can imagine that before the viability stage women would try anything.  I believe that its never been proven that bed rest has real effects either.  Just more non-science based medicine::::sigh:::::::

[evansfam813]

Jul. 15, 2008 at 2:22 PM I was given that drug and it didnt stop my conctrations at all. I ended up having my son at 31 weeks.