Acute tocolysis for fetal distress: terbutaline versus magnesium sulphate.
Forty-six women in active labour who developed fetal distress requiring abdominal delivery were randomized to receive 0.25 mg of terbutaline (subcutaneously) or magnesium sulphate as a 4-g bolus (intravenously) to decrease uterine activity. The terbutaline-treated group in contrast to the magnesium sulphate-treated group had reduced uterine activity as measured by Montevideo units (p < 0.002). This decrease in uterine activity was noted more rapidly in all 23 patients who received terbutaline, 1.8 +/- 0.74 minutes compared to 7.5 +/- 2.1 minutes in the 16 of 23 patients (magnesium sulphate-treated women) in whom a decrease in uterine activity occurred (p < 0.001). Umbilical cord arterial blood pH at delivery was less than 7.20 in only 2 of the 23 patients treated with terbutaline versus 7 of the 23 in the magnesium sulphate-treated group. We conclude that terbutaline is an effective and more rapid-acting tocolytic agent to arrest uterine activity prior to delivery for fetal distress.
Magann
E F
EF
Department of Obstetrics and Gynecology, University of Mississippi Medical Center.
Cleveland
R S
RS
Dockery
J R
JR
Chauhan
S P
SP
Martin
J N
JN
Morrison
J C
JC
D000328:Adult; D002585:Cesarean Section; D016009:Chi-Square Distribution; D005260:Female; D005316:Fetal Distress; D006801:Humans; D008278:Magnesium Sulfate / Q000494:pharmacology / Q000627:therapeutic use*; D011247:Pregnancy; D011446:Prospective Studies; D013726:Terbutaline / Q000494:pharmacology / Q000627:therapeutic use*; D015145:Tocolysis
D008278:Magnesium Sulfate; D013726:Terbutaline