Neonatal outcome was good. The factors that significantly affect the success rate of terbutaline administration in singleton pregnancy were cervical dilatation and cervical effacement.
Thus, terbutaline can be used safely for short-term treatment of preterm labor. Keywords: Factor; preterm labor; success rate; terbutaline; tocolysis. While showing some high average to superior intellectual functioning, patient B exhibited relative weaknesses on measures involving sustained attention, alternating attention, and working memory.
Nonetheless, these areas of cognitive functioning were not sufficiently impaired to significantly affect her academic potential. In terms of case conceptualization it is felt that patient B has some likely long-term abnormal cognitive patterns that have not been obvious due to her high level of intelligence. More recently, it is believed that her issues are more noticeable because school becomes more complicated and less structured as one prepares for and enters college.
Mild attention and executive issues can become more apparent. Thus, she received a diagnosis of cognitive disorder, not otherwise specified. Although the etiology could not be precisely determined, her extended prenatal terbutaline exposure was a significant risk factor in her developmental history.
Among the most common tocolytic drugs is terbutaline. It may slow or delay preterm labor and have great potential benefits but may be prescribed in ways that carry increased developmental risks.
The cases presented involve two adolescents who experienced an excessive prenatal terbutaline exposure, and who subsequently developed cognitive weaknesses to impairments during their childhood. In both cases there is no significant neurological history, but both have developmental histories involving weaknesses in attention skills.
However, aside from the attention issues, these individuals have very different cognitive profiles. Both cases have neuropsychological profiles which are highly unusual and possibly suggestive of early life brain injuries; however, it is conceivable that these individuals could have received some other diagnosis or none at all.
Based on prenatal and neonatal history it is possible that patient A may have had two potential brain insults, the terbutaline exposure and the possible effects, from a brief episode of neonatal cyanosis or hypoxia. Much more research will be needed to understand the effects of these variables. Neither case has a cognitive profile or reported symptoms definitive for either ADHD or a learning disorder. Both report attention problems and there is some evidence that the attention issues occur across settings.
Attention skills are highly susceptible to many factors and are thought to be possibly negatively affected by dysfunction in several different brain areas. Neither of these individuals has any significant psychiatric or other issues which could obviously affect attention skills. Understanding the exact etiology of the attention and other cognitive issues may help in choice of treatment options.
Moreover, it may be beneficial for children with significant terbutaline exposure to be closely followed or screened in early childhood, to help determine the need for early intervention. In cases such as these where there is no neurological history, birth trauma history, or family history of ADHD or learning disorders, it may be valuable for clinicians to ask about terbutaline or other prenatal exposures. It may be helpful for clinicians using terbutaline to be aware of the potential long-term developmental issues that may be associated with its use.
To help direct relevant clinical decisions, there is a great need for more empirical, controlled, and long-term follow-up studies on the long-term effects of terbutaline. The authors declare that there is no conflict of interests regarding the publication of this paper. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Received 25 May Accepted 26 Jun Published 15 Jul Abstract Preterm labor often leads to a preterm birth and has been shown to be the most important determinant of risk for perinatal morbidity and mortality.
Introduction The term preterm labor refers to a labor with a spontaneous onset prior to completing 37th week of gestation [ 1 ]. Case Studies 2. Patient A Patient A was a year-old African American boy who underwent a neuropsychological evaluation with emphasis on identifying attention deficits. Patient B Patient B was an year-old European American female who was referred for a neuropsychological evaluation because of problems with attention.
Discussion Since odds of both mortality and neurocognitive impairments dramatically diminish as gestational age progresses from 22 to 28 weeks, physicians will frequently opt for tocolysis treatment to reverse preterm labor and allow further development of the fetus [ 5 ]. Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper.
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Kaae, L. Agertoft, S. Pedersen et al. Pitzer, M. Schmidt, G. Esser, and M. Sanchez-Ramos, A. Kaunitz, F. Gaudier, and I. This site complies with the HONcode standard for trustworthy health information: verify here. This content does not have an English version. This content does not have an Arabic version. See more conditions. Drugs and Supplements Terbutaline Oral Route. Products and services.
Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Sign up now. Precautions Drug information provided by: IBM Micromedex It is very important that your doctor check the progress of you or your child at regular visits. Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.
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