Terbutaline vs Progesterone

Okay, so I went to see the perinatologist today about my contractions that started at 14 weeks and haven't subsided (15w1d now). She said it is definitely abnormal for me to be feeling them right now, but she was very nice and didn't make me feel stupid. She said I only really have 2 options right now.

1. Terbutaline- basically will just make me more comfortable by relaxing the uterus but will not postpone labor if that is what is to happen

2. progesterone injections- which will not necessarily stop these contractions but has been known to prevent preterm labor

Here is my question. I opted for the terbutaline (without knowing much about it) because I was scared of long term progesterone use. But the more I am reading, it seems like the terbutaline could be bad for baby and shouldn't be used long term (during pregnancy), while the progesterone is very safe and could PREVENT pre-term labor. Anyone have any experience with any of this and suggestions?? I might call her back and switch to progesterone, but I would like to hear some input from BTDT.

[hopeful thoughts]

Oh and I forgot to add that one of the side effects for terbutaline is rapid heart rate and it says baby;s could go up to. My babe's is already 150-156 at times so I defintiely don't want it to go higher.

[Darkestlight]

Honestly, I would go with progesterone, but that is my personal opinion based on the research that I have done and the fact you are only 15wks along. You need to try to prevent preterm labor. A baby is not considered viable till 24wks so you are really going to want to look for the best route to prevent labor before then because if you go into full blown labor most doctors won't try to resuscitate the baby if it's before then.

[peekawho]

They're starting to use a type of progesterone injection after a few studies have shown that it may help to prevent preterm labor.  I don't know how well it work, how well controlled the studies were, and what long term effects on the baby might be.  I've seen one or two ladies on it long term, both delivered preterm anyway, but maybe not as early as they might have without it, who knows?

Usually, they do not use Terbutaline this early, so I don't know what the long term effects are of using it that early are either.  I've seen women on it from about 22 weeks or so on.  

Which did the perinatologist recommend?  

[hopeful thoughts]

She didn't really go one way or the other. I told her I would rather be on something prn and she said that then my option was terbutaline prn. But the progesterone would have to be consistent for the rest of the pregnancy, And yes you are right, she said short term studies have shown no lasting effects, but there have not been any long term studies done yet.

I think I am going to switch to the progesterone. I am just having a bad feeling about the terbutaline, even though my does would be 1.75mg 2x/day prn (so very small dose)

[peekawho]

Thats an extremely small dose.  We give 2.5mg every 4 hours, or 5 mg every 6 hours.

I'd probably go with the progesterone, too.  Understand that you might wind up on the Terbutaline later, anyway.

Another drug they sometimes use later is Nifedipine, its an oral drug.  And again, later on, they often try Indocin for 48 hours.

[hopeful thoughts]

Thanks soooo much for the info. I figure I will probably need the terbutaline later on, so I want it to be effective when I really know I need it to be. I read that sometimes prolonged use can make it less effective. I would like to see if I can make it to 20-22 weeks with no cervical changes before I start using it. I have an appointment on Friday and I think I will switch to the progesterone. Thanks again.

[taysmommy]

i was on the terb, but i started at about 28 weeks, and mine was every 4 hours....

i dont know about the immidiate side effects of the progesterone, but the terb made me feel like i was on drugs( no ive never done drugs, but it made me shakey (shaky) and felt like my heart was racing all the time), i could hardly sleep, from what ive heard about it, its a steriod, so it makes you feel awful so hopefully you can go for the progesterone and it will work for you.....

there isnt anything wrong with my dd, and i was on the terb for ohhhhh.....9 weeks or so, im not sure if thats considered long term use, but just wanted to add that incase you do go for the terb

[mamatbg]

Yes, Yes I would switch to progesterone as soon as possible. I had progesterone injections starting at 20wks preg. and the only side effects were that they made me sleepy. At 32 wks. I had contractions at 4 mins.  apart and was given terbutaline to stop them. My heart rate ran rapid and it was scary. The baby's heart rate was beating very fast also and she was moving all over the place. My high risk Obgyn said if I had contractions like that again that they would not give another dose of the terbutaline to stop the contractions and that it was safer for baby if  I went ahead and delivered her than to risk heart problems or other complications from the terbutaline.
I am now 35wks and all is well. The high risk obgyn does ultra sounds with every visit and the baby and her heart looks totally healthy.

I also have a friend who was given terbutaline consistently  when she was pregnant and her daughter had a mild heart condition as a result. Her daughter is mostly healthy now but they do monitor her heart from time to time.