title: Prevention of preterm birth: early detection and aggressive treatment with terbutaline.
abstract: We evaluated a program for prevention of preterm birth involving early detection and aggressive intervention with subcutaneous terbutaline pump therapy in a high-risk, private patient population. Risk factor screening, frequent cervical examinations, and intensive patient education were used to detect preterm labor before it progressed to an advanced stage. Home terbutaline pump therapy was prescribed for patients with uterine contractions associated with progressive cervical change, after stabilization with IV magnesium sulfate. In this study of 51 patients, home terbutaline pump therapy was successful in 98% of the cases, prolonging pregnancy an average of 6.6 weeks. Mean gestational age at delivery was 37 +/- 1.4 weeks, and infant birth weight averaged 3 kg. Only 22% of infants required admission to the neonatal intensive care unit, with a mean length of stay of 7.25 days. Population factors in this compliant, well-educated patient group may have contributed to the positive outcomes achieved.
authors.affiliation: PharmaThera Inc, Nashville, Tennessee.
authors.forename: R T
authors.initials: RT
authors.lastname: Adkins
authors.forename: J E
authors.initials: JE
authors.lastname: Van Hooydonk
authors.forename: P L
authors.initials: PL
authors.lastname: Bressman
authors.forename: J H
authors.initials: JH
authors.lastname: Growdon
authors.forename: P R
authors.initials: PR
authors.lastname: Bolen
authors.forename: J C
authors.initials: JC
authors.lastname: Varin
authors.forename: B R
authors.initials: BR
authors.lastname: Thompson
mesh_terms: D000328:Adult; D001724:Birth Weight; D002584:Cervix Uteri / Q000473:pathology; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D007263:Infusions, Parenteral; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008403:Mass Screening / Q000592:standards*; D007752:Obstetric Labor, Premature / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D010808:Physical Examination; D011247:Pregnancy; D011256:Pregnancy Outcome; D015397:Program Evaluation; D012307:Risk Factors; D012651:Self Medication / Q000379:methods / Q000592:standards; D013726:Terbutaline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D008278:Magnesium Sulfate; D013726:Terbutaline