The effect of tocolytic agents (indomethacin and terbutaline) on fetal breathing and body movements: A prospective, randomized, double-blind, placebo-controlled clinical trial

Abstract

OBJECTIVE: The null hypothesis of this study is that maternal administration of indomethacin orterbutaline will not affect fetal breathing and body movements. STUDY DESIGN: Thirty patients with a low-risk pregnancy, gestational age 26 to 32 weeks, and no signsof preterm labor were randomly assigned to receive either terbutaline (5 mg), indomethacin (50 mg), or a placebo. Ultrasonographic evaluation of fetal breathing and body movements was performed for 1 hour before and 1 hour after treatment. The total amount of time of fetal breathing and body movements in each group was subject to statistical analysis that included analysis of variance and covariance and a multiple comparison procedure. RESULTS: Indomethacin increased fetal breathing from 20.8 ± 13.1 minutes to 42.2 ± 14.8 minutes( p < 0.01), whereas terbutaline increased fetal breathing movements from 19.8 ± 9.0 minutes to 35.2 ± 12.4 minutes ( p < 0.01). No significant treatment effect was detected on fetal body movements. CONCLUSION: Between 26 and 32 weeks' gestation, a single dosage of indomethacin or terbutalineincreases fetal breathing movements by 103% and 78%, respectively. ( Am J Obstet Gynecol 1992;167:1059–63.)