Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial.
OBJECTIVE
Preterm labor (PTL) is a common medical problem during pregnancies and is associated with neonatal mortality and morbidity. Beta-adrenergic agonists are among the most commonly used tocolytic agents. The aim of this study was to compare the effectiveness, safety and adverse effects of terbutaline with those of salbutamol in the prolongation of pregnancy beyond 48 hours and until 37 weeks of gestation.


METHODS
Two hundred women with PTL were randomly assigned to receive subcutaneous terbutaline (250 μg) or intravenous salbutamol (0.1 mg) followed by oral terbutaline (20 mg/d) or oral salbutamol (24 mg/d) as maintenance. The efficacy, side effects and complications after 48 hours and until 37 weeks of gestation were analyzed and compared.


RESULTS
There was no significant difference between the two groups in success rate within 48 hours (P= .091). Gestational age at delivery (P=.031) and the number of days for which the gestation was prolonged (P=.024) were significantly higher in those receiving terbutaline. Adverse effects, including tachycardia (P=.007) and anxiety (P=.006), were experienced more in the salbutamol group. Birth weight was significantly lower in the salbutamol group (P=.001).


CONCLUSIONS
Terbutaline provided more effective tocolysis with fewer adverse effects and a better neonatal outcome. However, terbutaline and salbutamol are equally effective in the first 48 hours.
Motazedian
Shahdokht
S
Fasa University of Medical Sciences, Fasa, Iran.
Ghaffarpasand
Fariborz
F
Mojtahedi
Khatereh
K
Asadi
Nasrin
N
D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000420:Albuterol / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D013726:Terbutaline / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D015149:Tocolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
D058666:Adrenergic beta-2 Receptor Agonists; D015149:Tocolytic Agents; D013726:Terbutaline; D000420:Albuterol