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Peripartum heart failure associated with prolonged tocolytic therapy
M B Lampert1, J Hibbard, L Weinert
1Department of Medicine, University of Chicago Medical Center, IL 60637.
American Journal of Obstetrics and Gynecology
|February 1, 1993
Summary
Chronic terbutaline therapy, a beta-adrenergic agonist used for preterm labor, may be linked to peripartum cardiomyopathy. Women receiving long-term tocolysis require close cardiac function monitoring.
Area of Science:
- Cardiology
- Obstetrics
- Pharmacology
Background:
- Beta-adrenergic receptor agonists are used for tocolysis to prevent preterm labor.
- Previous reports suggest these agents can cause noncardiogenic pulmonary edema.
- The association between chronic tocolysis and cardiomyopathy in peripartum women is not well-established.
Purpose of the Study:
- To investigate the potential association between chronic terbutaline therapy and the development of cardiomyopathy in peripartum women.
- To evaluate cardiac function recovery in patients with peripartum heart failure who received prolonged terbutaline tocolysis.
Main Methods:
- Retrospective case series analysis of 15 gravidas presenting with peripartum heart failure.
- Review of medical records to identify patients who received prolonged terbutaline tocolysis.
- Assessment of left ventricular function and recovery patterns.
Main Results:
- Four out of 15 patients with peripartum heart failure had received prolonged terbutaline tocolysis.
- These four patients demonstrated complete normalization of ventricular function.
- Of the 11 patients without prior terbutaline exposure, only 7 showed full recovery of cardiac function.
Conclusions:
- Chronic terbutaline therapy may be associated with peripartum cardiomyopathy.
- Long-term use of beta-sympathomimetic tocolysis warrants close cardiac function evaluation in pregnant individuals.
- Prompt cardiac assessment is recommended for gravidas undergoing extended tocolytic treatment.