Pregnancy prolongation in triplet pregnancies. Oral vs. continuous subcutaneous terbutaline.

OBJECTIVE: To assess gestational gain in triplet pregnancies treated with oral terbutaline followed by treatment with continuous subcutaneous terbutaline. STUDY DESIGN: From a database of patients who received perinatal home care services, we identified women with triplet gestations first receiving daily oral terbutaline following an episode of threatened preterm labor who subsequently received continuous subcutaneous terbutaline infusion after recurrence of preterm contractions. The primary outcome studied was gestational gain with oral terbutaline vs. gestational gain with continuous subcutaneous terbutaline infusion. RESULTS: One hundred four women were studied. The mean gestational age at enrollment was 22.0 +/- 2.7 weeks. Significantly more gestational gain was achieved during subcutaneous tocolytic treatment than during oral treatment (mean 5.4 +/- 3.4 vs. 2.8 +/- 2.2 weeks, P < .001). Twenty-nine percent of desired prolongation was achieved with oral terbutaline, while 71% of desired prolongation was achieved with subcutaneous terbutaline infusion (P < .001). The mean gestational age at delivery was 33.2 +/- 2.2 weeks. CONCLUSION: Gestational gain was greater in triplet pregnancies during treatment with continuous subcutaneous terbutaline infusion than with oral terbutaline.