Long-term tocolysis with combined intravenous terbutaline and magnesium sulfate: a 10-year study of 1000 patients.

Abstract

OBJECTIVE:

To determine whether long-term intravenous (IV) tocolysis using combined terbutaline and magnesium sulfate is safe and effective.

METHODS:

One thousand consecutive women in preterm labor were treated with combination IV tocolytic therapy. Terbutaline was initiated with an infusion rate of 1.75 micrograms/minute and increased to a maximum of 80 micrograms/minute. Magnesium sulfate was infused at 2 g/hour without any bolus and increased to maintain a serum level of 6.5-7.5 mg/dL. Tocolysis was continued until fetal lung maturity was achieved or delivery occurred.

RESULTS:

Combination tocolytic therapy prolonged pregnancy by a mean (+/- standard deviation) of 61 +/- 23.6 days in 751 women with intact membranes and by 20.5 +/- 17.4 days in 249 with ruptured membranes. The longest durations of continuous IV tocolysis were 123 days in a patient with intact membranes and 77 days in one with ruptured membranes. The most common side effects were nausea and vomiting, followed by chest tightness and shortness of breath.

CONCLUSION:

Long-term IV tocolysis appeared to be safe and to have acceptable side effects, allowing patients to receive combined terbutaline and magnesium sulfate until delivery.

• Authors: T S Kosasa, R Busse, N Wahl, G Hirata, R T Nakayama, R W Hale
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 84 Issue 3 Pg. 369-73 (Sep 1994) ISSN: 0029-7844 [Print] United States
• PMID: 8058233 (Publication Type: Journal Article)

Chemical References

• Magnesium Sulfate
• Terbutaline

Topics

• Adult
• Drug Therapy, Combination
• Female
• Fetal Membranes, Premature Rupture (drug therapy)
• Humans
• Infusions, Intravenous
• Magnesium Sulfate (administration & dosage, therapeutic use)
• Obstetric Labor, Premature (prevention & control)
• Pregnancy
• Prospective Studies
• Terbutaline (administration & dosage, therapeutic use)
• Time Factors
• Tocolysis (methods)