Randomised controlled trial of effect of terbutaline before elective caesarean section on postnatal respiration and glucose homeostasis
Karolinska
Institute, Astrid Lindgren Children's Hospital, Stockholm, Sweden
Correspondence to: Professor H Lagercrantz Neonatal Unit Karolinska Hospital S-171 76 Stockholm Sweden.
Accepted 11
August 1998
AIM
To determine if
terbutaline given to mothers before elective caesarean section
facilitates neonatal respiration and metabolism.
METHODSA randomised
controlled trial of 25 full term infants delivered by elective
caesarean section was conducted. The mothers received a continuous
infusion of terbutaline or saline 120-0 minutes before birth.
Umbilical artery blood was collected at birth and analysed for blood
gases and catecholamines. The lung function of each infant was assessed
two hours after birth, and blood pressure, heart rate, blood glucose
and body temperature were monitored until 24 hours of age.
RESULTSThe infants of
the treated mothers (n=13) had significantly higher dynamic lung
compliance (p<0.001), lower airway resistance (p<0.001), and
respiratory frequency than control infants (n=12). Blood glucose and
adrenaline concentrations were significantly higher in the treated
group (p=0.0014 and p<0.01). None of these infants had any clinical
respiratory difficulties; there were two cases of transient tachypnoea
in the control group. No negative side effects due to the terbutaline
treatment were seen among the infants. The mothers felt no discomfort
caused by the terbutaline infusion, although they bled more during
surgery (p=0.03).
CONCLUSIONStimulation
of the 
adrenoceptors in utero with terbutaline infusion to the
mothers promotes neonatal respiratory and metabolic adaptation after
elective caesarean section.
© 1999 by Archives of Disease in Childhood
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