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Terbutaline pump maintenance therapy after threatened preterm labor for preventing preterm birth

Overview of attention for article published in Cochrane database of systematic reviews, October 2002
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Title
Terbutaline pump maintenance therapy after threatened preterm labor for preventing preterm birth
Published in
Cochrane database of systematic reviews, October 2002
DOI 10.1002/14651858.cd003933
Pubmed ID
Authors

Kavita Nanda, Lynley A Cook, Maria F Gallo, David A Grimes

Abstract

Women with preterm labor that is arrested with tocolytic therapy are at increased risk of recurrent preterm labor. Terbutaline pump maintenance therapy has been given to such women to decrease the risk of recurrent preterm labor, preterm birth, and its consequences. To determine the effectiveness and safety of terbutaline pump maintenance therapy after threatened preterm labor in preventing preterm birth and its complications. We searched the Cochrane Pregnancy and Childbirth Group trials register (searched May 2002) and the Cochrane Controlled Trials Register (Cochrane Library Issue 2, 2002). Randomized trials comparing terbutaline pump maintenance therapy with alternative therapy, placebo, or no therapy after threatened preterm labor. Two reviewers independently assessed the studies for inclusion and then extracted data from eligible studies. We included two studies. Terbutaline pump maintenance therapy did not appear to offer any advantages over the saline placebo pump or oral terbutaline maintenance therapy in preventing preterm births by prolonging pregnancy or its complications among women with arrested preterm labor. The weighted mean difference (WMD) for gestational age at birth was -0.1 weeks (95% confidence interval (CI) -1.7 to 1.4) for terbutaline pump therapy compared with saline placebo pump for both trials combined and 1.4 weeks (95% CI -1.1 to 3.9) for terbutaline pump versus oral terbutaline therapy for the first trial. The second trial reported a relative risk (RR) of 1.17 (95% CI 0.79 to 1.73) of preterm birth (less than 37 completed weeks) and a RR of 0.97 (95% CI 0.51 to 1.84) of very preterm birth (less than 34 completed weeks) for terbutaline pump compared with saline placebo pump. Terbutaline pump therapy also did not result in a higher rate of therapy continuation or a lower rate of infant complications. No data were reported on long-term infant outcomes, costs, or maternal assessment of therapy. Terbutaline pump maintenance therapy has not been shown to decrease the risk of preterm birth by prolonging pregnancy. Furthermore, the lack of information on the safety of the therapy, as well as its substantial expense, argues against its role in the management of arrested preterm labor. Future use should only be in the context of well-conducted, adequately powered randomized controlled trials.

Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Ireland 1 3%
Unknown 39 98%

Demographic breakdown

Readers by professional status Count As %
Unspecified 7 18%
Researcher 7 18%
Student > Master 7 18%
Other 6 15%
Student > Ph. D. Student 4 10%
Other 9 23%
Readers by discipline Count As %
Medicine and Dentistry 20 50%
Unspecified 8 20%
Social Sciences 4 10%
Biochemistry, Genetics and Molecular Biology 2 5%
Psychology 2 5%
Other 4 10%