Terbutaline and preterm labor. Just say no.

I am struck by the number of women who are taking or who have taken terbutaline to prevent a premature delivery.

So what’s the big deal you ask? Well, it doesn’t work. This is a medical fact, because it has been studied extensively. Using oral terbutaline is no more effective than placebo at stopping preterm labor. In fact, the American Congress of Obstetricians and Gynecologists states that using oral terbutaline should not be “undertaken as a general practice.” And trust me, they are a conservative bunch. If they say don’t do something they have mulled over it for a good, long time.

But what if your friend took terbutaline and she swears it stopped her labor?

Well, not all preterm contractions are labor, and not everyone with preterm labor delivers prematurely. So some women will simply stop on their own. Studies tell us that terbutaline is simply not any better than doing nothing. So, if you know someone who swears their labor stopped because of terbutaline, there is high quality medical evidence to say it would have stopped anyway.

Terbutaline is also not risk free. It can have dangerous effects on the heart and at least 16 mothers have died as a result of the drug.

Terbutaline now has a black box warning highlighting these risks. The FDA says that  injectable terbutaline to prevent preterm labor (given in the hospital) should not be used for more than 48 to 72 hours because of the risk for maternal heart problems and death. (I say it shouldn’t be used at all, because indomethacin is a better tocolytic).

In addition, oral terbutaline at home should not be used AT ALL for the prevention or treatment of preterm labor as it has the same risks as the injectable form and is ineffective.

The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better because she is doing something/think maybe it reduces contractions so they will get less calls (it doesn’t). All of these are the wrong reasons to prescribe a medication.

If your doctor recommends terbutaline, I would probably start looking for another doctor. My concern? If he/she is recommending one therapy that not only doesn’t work, but is potentially harmful, what other recommendations might be not only woefully out of date, but potentially harmful?

Remember, this blog is not individual medical advice.

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9 Responses to Terbutaline and preterm labor. Just say no.

  1. Pingback: Tweets that mention Terbutaline and preterm labor. Just say no. | The Preemie Primer Guide from Dr. Jen Gunter -- Topsy.com

  2. marissa says:

    When I was hospitalized with preterm labor, I was on a terbutaline pump, and I still had contractions every day until my baby was born.

  3. jen says:

    I was given terbutaline to stop preterm labor at 34 weeks. When I didn’t take it regularly as prescribed by my doctor I was lectured for puting my baby at risk. Truth is it made my heart race, left me feeling shaky, and I figured if it was doing that to me what was it doing to my baby?? Baby came two days past my due date. It’s a shame we can’t trust our doctors sometimes.

  4. Jim says:

    First, do no harm!

  5. Jessica says:

    I was given Terbutaline (injections and oral) for over a month. I finally stopped taking it because I couldn’t sleep and couldn’t drive because I was so shaky. My daughter still ended up being born 3 weeks early and she has congenital heart defects that required angioplasty at 2 months of age and open heart surgery at 3 months. I have been assured by two surgeons and her cardiologist that this condition is not hereditary and it was not caused by anything I did during the pregnancy…there was no way I caused her heart condition…there is also absolutely no history of heart disease in my family. I would advise every pregnant mother to STAY AWAY from Terbutaline!

  6. cheryl says:

    Jessica, thank you for sharing your story! I hope your daughters is getting stronger by the day.

  7. Patricia says:

    I am not convinced one way or the other. I have been on trebutaline with both of my previous pregnancies and both times I went into labor within 48hrs of stopping the drug one at 37wk and one at 36wks. I will say it was one of the most miserible bits of medication I ever took. I hated every second I was on it. Both of my babies were born healthy (although small) and there were no long term side effects for me or them. I don’t get a lot of warning when I go into active labor. I have no pain just a little pressure that comes and goes and then my water breaks so the odds that I could get to a hospital and get it stopped are slim. I am pregnant again 22wks and I have a as needed trebutaline perscription. I will avoid taking it as long as I possibly can but once I start getting more regular contractions (I already have them) I don’t know what other options I have. Drugs are dangerous sometimes but having a baby born before their lungs develop is dangerous all the time.

  8. Marilize says:

    My dr put me on terbutaline as I started preterm labor @ 31 wks. At 32wks contractions started again&was admitted in hosp was given terbutaline every 8hrs. I t made me feel horrible we were very concerned about the effects it is having on our baby girl. Scary how persistent the drs r that its doing no harm to her. After reading this I’m stopping it immediately. We have been argueing the reason why she wants to be born as this is our second child& the 1st was born at 38wks. Ill rather have a prem baby that is healthy than full term baby that has medical complications!!!

  9. jennifer says:

    wow. i just got a dose of it this afternoon to stop the contractions i was having. i’m only 29 weeks and the contractions had me in tears and griping the bed but no cervix change. so now i’m thinking that if my contractions start back up (which they feel to be doing gradually) and i have to go back in, i will tell them no to that drug.

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