Continuous subcutaneous terbutaline administration prolongs pregnancy after recurrent preterm labor

Abstract

Objective: This study was undertaken to study the effectiveness of continuous subcutaneous terbutaline (SQT) in the home after recurrent preterm labor (RPTL). Study Design: Women with RPTL at less than 32 weeks' gestation were treated with continuous SQT administered in the home compared with matched control patients. Results: Fifteen SQT patients were compared with 45 women (3:1) treated with no tocolytic therapy after hospitalization. Gestational age at delivery more than 37 weeks (53% vs 4%), percentage delivered at less than 32 weeks (0% vs 47%), overall and pregnancy prolongation (49.8 ± 19.2 days vs 24.5 ± 12.8 days) were all significantly better in the study group (P <.001). The total number of maternal hospital days (9.8 ± 2.1 vs 15.9 ± 7.4, P <.0001), duration of NICU stay (1.9 ± 4.9 vs 19.8 ± 29.3 days, P <.001), and total cost for newborn care ($6,995 ± $14,822 vs $62,033 ± $89,978, P <.002) favored the study patients. For every dollar spent on SQT, there was a savings of $4.67 in newborn hospital costs for control patients. Conclusion: In this small study, the use of SQT significantly prolongs pregnancy, decreases serious neonatal complications, and reduces the duration of hospitalization for both mother and infant, as well as neonatal costs. (Am J Obstet Gynecol 2003;188:1460-7.)