American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 414.e1-414.e6 , October 2007

Randomized comparison of intravenous terbutaline vs nitroglycerin for acute intrapartum fetal resuscitation

Presented at the 27th Annual Clinical Meeting of the Society for Maternal–Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

  • Kristin M. Pullen, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA
    • ,
  • Edward T. Riley, MD

      Affiliations

    • Department of Anesthesia, Stanford University, Stanford, CA
    • ,
  • Sarah A. Waller, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA
    • ,
  • Larisa Taylor, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA
    • ,
  • Aaron B. Caughey, MD, PhD

      Affiliations

    • Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, CA.
    • ,
  • Maurice L. Druzin, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA
    • ,
  • Yasser Y. El-Sayed, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Stanford University, Stanford, CA

References 

  1. American College of Obstetricians and Gynecologists. Intrapartum fetal heart rate monitoring: ACOG practice bulletin no. 70. Obstet Gynecol. 2005;106:1453–1461
  2. Kulier R, Hofmeyr GJ. Tocolytics for suspected intrapartum fetal distress. Cochrane Database Syst Rev. 2000;2:CD000035
  3. Patriarco MS, Viechnicki BM, Hutchinson TA, Klasko SK, Yeh SY. A study on intrauterine fetal resuscitation with terbutaline. Am J Obstet Gynecol. 1987;157:384–387
  4. Magann EF, Cleveland RS, Dockery JR, Chauhan SP, Martin JN, Morrison JC. Acute tocolysis for fetal distress: terbutaline versus magnesium sulfate. Aust N Z J Obstet Gynaecol. 1993;4:362–366
  5. Burke SM, Porreco RP, Day D, et al. Intrauterine resuscitation with tocolysis- an alternative month clinical trial. J Perinatol. 1989;9:296–300
  6. Arias F. Intrauterine resuscitation with terbutaline: a method for the management of acute intrapartum fetal distress. Am J Obstet Gynecol. 1978;131:39–43
  7. Ingemarsson I, Arulkumaran S, Ratnam SS. Single injection of terbutaline in term labor- effect on fetal pH in cases of prolonged bradycardia. Am J Obstet Gynecol. 1985;153:859–864
  8. Mendez-Bauer C, Shekarloo A, Cook V, Freese U. Treatment of acute intrapartum fetal distress by β-2 sympathomimetics. Am J Obstet Gynecol. 1987;156:638–642
  9. Tejani NA, Verma UL, Chatterjee S, Mittelmann S. Terbutaline in the management of acute intrapartum fetal acidosis. J Reprod Med. 1983;28:857–861
  10. Shekarloo A, Mendez-Bauer C, Cook V, Freese U. Terbutaline (intravenous bolus) for the treatment of acute intrapartum fetal distress. Am J Obstet Gynecol. 1989;160:615–618
  11. Kulier R, Gülmezoglu A, Hofmeyr GJ, Van Gelderen CJ. Betamimetics in fetal distress: a randomized controlled trial. J Perinat Med. 1997;25:97–100
  12. Afschar P, Schöll W, Bader A, Bauer M, Winter R. A prospective randomized trial of atosiban versus hexoprenaline for acute tocolysis and intrauterine resuscitation. BJOG. 2004;111:316–318
  13. Kubli FW, Hon EH, Khazin AE, et al. Observations on heart rate and pH in the human fetus during labor. Am J Obstet Gynecol. 1969;104:1190–1206
  14. National Institute of Child Health and Human Development Research Planning Workshop. Electronic fetal heart rate monitoring: research guidelines for interpretation. Am J Obstet Gynecol. 1997;177:1385–1390
  15. Caponas G. Glyceryl trinitrate and acute uterine relaxation: a literature review. Anaesth Intensive Care. 2001;29:163–177
  16. O’Grady JP, Parker RK, Patel SS. Nitroglycerin for rapid tocolysis: development of a protocol and a literature review. J Perinatol. 2000;1:27–33
  17. Axemo PA, Fu X, Lindberg B, Ülmsten U, Wessen A. Intravenous nitroglycerin for rapid uterine relaxation. Acta Obstet Gynecol Scand. 1998;77:50–53
  18. Lowenwirt IP, Zauk RM, Handwerker SM. Safety of intravenous glyceryl trinitrate in management of retained placenta. Aust N Z J Obstet Gynaecol. 1997;37:20–24
  19. Redick LF, Livingstone E. A new preparation of nitroglycerin for uterine relaxation. Int J Obstet Anesth. 1995;4:14–16
  20. DeSimone CA, Norris MC, Leighton BL. Intravenous nitroglycerin aids in manual extraction of a retained placenta. Anesthesiology. 1990;73:787
  21. Peng ATC, Gorman RS, Shulman SM, DeMarchis E, Nyunt K, Blanacato LS. Intravenous nitroglycerin for uterine relaxation in the postpartum patient with retained placenta. Anesthesiology. 1989;71:172–173
  22. El-Sayed YY, Pullen K, Riley ET, et al. Randomized comparison of intravenous nitroglycerin and subcutaneous terbutaline for external cephalic version under tocolysis. Am J Obstet Gynecol. 2004;191:2051–2055
  23. Bujold E, Marquette G, Ferreira E, Gauthier R, Boucher M. Sublingual nitroglycerin versus intravenous ridodrine as tocolytic for external cephalic version: a double-blinded randomized trial. Am J Obstet Gynecol. 2003;188:1454–1459
  24. Redick LF, Livingston E, Bell E. Sublingual aerosol nitroglycerin for uterine relaxation in attempted external version. Am J Obstet Gynecol. 1997;176:496–497
  25. Yanny H, Johanson R, Baldwin KJ, Lucking L, Fitzpatrick R, Jones P. Double-blind randomised controlled trial of glyceryl trinitrate spray for external cephalic version. BJOG. 2000;107:562–564
  26. El-Sayed YY, Riley ET, Holbrook RH, Cohen SE, Chitkara U, Druzin ML. Randomized comparison of intravenous nitroglycerin and magnesium sulfate for treatment of preterm labor. Obstet Gyecol. 1999;93:79–83
  27. Smith GN, Walker MC, Ohlsson A, O’Brien K, Windrim R. Randomized double-blind placebo-controlled trial of transdermal nitroglycerin for preterm labor. Am J Obstet Gynecol. 2007;196:37.e1–37.e8
  28. Bell E. Nitroglycerin and uterine relaxation. Anesthesiology. 1996;85:683
  29. Mercier FJ, Dounas M, Bouaziz H, Lhuissier C, Benhamou D. Intravenous nitroglycerin to relieve intrapartum fetal distress related to uterine hyperactivity: a prospective observational study. Anesth Analg. 1997;84:1117–1120
  30. Garite TJ, Dildy GA, McNamara H, et al. A multicenter controlled trial of fetal pulse oximetry in the intrapartum management of nonreassuring fetal heart rate patterns. Am J Obstet Gynecol. 2000;183:1049–1058
  31. Mahomed K, Nyoni R, Mulambo T, Kasule J, Jacobus E. Randomised controlled trial of intrapartum fetal heart rate monitoring. BMJ. 1994;308:497–500

 Reprints not available from the authors.

 Cite this article as: Pullen KM, Riley ET, Waller SA, et al. Randomized comparison of intravenous terbutaline vs nitroglycerin for acute intrapartum fetal resuscitation. Am J Obstet Gynecol 2007;197:414.e1-414.e6.

PII: S0002-9378(07)00839-3

doi: 10.1016/j.ajog.2007.06.063

American Journal of Obstetrics & Gynecology
Volume 197, Issue 4 , Pages 414.e1-414.e6 , October 2007

Article Tools

* Image Usage & Resolution