When a mom-to-be is struck with preterm labor, all she and the father can think about is stopping it. Every day that full labor can be fought off is another day of development for their baby, and in this case, a single day means a lot.

The medications to stop preterm labor are varied, as are their results. Some generate a great deal of controversy on their safety and effectiveness. But perhaps no drug for preterm labor has generated more debate than terbutaline.

Dr. Randy A. Fink, a board certified OB/GYN in private practice in Miami, Fla., as well as a Fellow of the American College of Obstetricians and Gynecologists, says that terbutaline is from a class of drugs known as beta-adrenergic receptor agonists. These drugs cause relaxation of smooth muscle, such as that of the uterus. The drug is approved by the FDA for treating asthma.

"When the uterus is contracting, such as during preterm labor, we would like to have a way to stop this activity – to relax the uterine muscles and stop the contractions," Dr. Fink says. "A similar medication known as ritodrine was approved by the Food and Drug Administration (FDA) in 1980 as a labor-inhibiting agent (known as a tocolytic), but the drug is no longer available on the market. Since terbutaline is so similar, it is frequently used for this purpose even though it is not FDA approved for labor inhibition."

Dr. Fink says it is important when looking at the effectiveness of any preterm labor drug to understand the difference between preterm labor and preterm contractions. The uterus is a muscle that is built to do one thing: contract. Many pregnant women have crampy preterm uterine contractions that cause them to present to labor and delivery units for evaluation and treatment. Terbutaline is often given in the form of a subcutaneous injection to stop these annoying uterine contractions. Terbutaline can also be given in oral form (a pill) for pregnant women to take at home to stop contractions.

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