title: Management of uterine hyperstimulation with concomitant use of oxytocin and terbutaline.
abstract: The purpose of this study was to evaluate the efficacy of the concomitant use of subcutaneous terbutaline and oxytocin for the management of uterine hyperstimulation. Patients in active labor receiving intravenous oxytocin who developed uterine hyperstimulation were randomly assigned to receive either oxytocin discontinuation or administration of subcutaneous terbutaline while maintaining the oxytocin infusion. Time to resolution of hyperstimulation was the primary end point. Twenty-nine patients were enrolled. The most frequent types of hyperstimulation were tachysystole (26%) and mixed patterns (26%). Resolution time was significantly shorter in the combination therapy versus control ( P = 0.002). Persistence of hyperstimulation 15 minutes after intervention was seen in 53% of the women in the control group versus 0% of the women in the study group. No significant differences were noted in the Apgar scores, rates of cesarean sections, or chorioamnionitis. In the management of uterine hyperstimulation, subcutaneous terbutaline without discontinuation of oxytocin is more effective than the traditional approach of oxytocin discontinuation.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77555, USA.
authors.forename: Luis D
authors.initials: LD
authors.lastname: Pacheco
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Rosen
authors.forename: Alfredo F
authors.initials: AF
authors.lastname: Gei
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Gary D V
authors.initials: GD
authors.lastname: Hankins
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D007751:Labor, Induced; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013726:Terbutaline / Q000008:administration & dosage*; D015149:Tocolytic Agents / Q000008:administration & dosage*; D016896:Treatment Outcome; D014590:Uterine Contraction / Q000187:drug effects*
chemical_list: D015149:Tocolytic Agents; D010121:Oxytocin; D013726:Terbutaline