Denise M. Main

EXTENDED LONGITUDINAL STUDY OF UTERINE ACTIVITY AMONG LOW-RISK WOMEN

Eighty-nine black women without major medical risks for preterm labor participated in this longitudinal, prospective study for the evaluation of usual prelabor uterine activity and for the assessment of how gestational age, time of day, maternal weight, age, and parity affected contraction frequency. Participants wore an ambulatory tocodynamometer for 72 consecutive hours at three points in gestation during the second and early third trimesters while engaged in usual home and work activity. Data obtained from the 81 women with uncomplicated term pregnancies demonstrated a significant increase in contraction frequency with advancing gestational age between 22 and 33 weeks. After 26 weeks, significantly more uterine activity occurred at night. Perhaps because of detection difficulties, contraction frequency was inversely related to maternal weight in women weighing > 112% ideal weight. Maternal age and parity did not affect contraction frequency. Contraction characteristics of eight women experiencing preterm labor or medically indicated preterm delivery are described.

Chronic oral terbutaline tocolytic therapy is associated with maternal glucose intolerance

Plasma glucose determinations were performed 1 hour after a 50 gm oral glucose load in 30 patients receiving long-term terbutaline therapy (20 to 40 mg/day for at least 1 week) and 247 normal control patients. A total of 63% of patients receiving terbutaline had an abnormal 1-hour value (greater than or equal to 140 mg/dl), an incidence much higher than that of control subjects (17.8%) (p less than 0.0001) for a relative risk of 3.54 (95% confidence intervals of 2.29 to 5.42). Mean 1-hour values were 112.1 mg/dl for control subjects and 149.8 mg/dl in the terbutaline group (p less than 0.0001). All abnormal values were followed by a 3-hour 100 gm oral glucose tolerance test. A total of 15.9% of the glucose tolerance tests performed in the control group (2.8% overall) were abnormal as opposed to 52.6% (33.1% overall) in patients receiving terbutaline (p less than 0.01). Nine patients were studied before and after terbutaline therapy. Results obtained during administration of terbutaline were significantly higher (102.2 mg/dl before therapy versus 145.2 mg/dl during therapy). We conclude that treatment with oral terbutaline appears to be associated with impairment of glucose tolerance in pregnancy.