? precipitous labor

L&Dnurse2Be · Mar 28, 2009

Isn't terbutaline used to relax the uterus, slowing/stopping contractions? Nasty side effects though, shaking, tremors, etc. Correct me if I'm wrong.

romantic, BSN, RN · Mar 28, 2009

Isn't terbutaline used to relax the uterus, slowing/stopping contractions? Nasty side effects though, shaking, tremors, etc. Correct me if I'm wrong.

Yes, and also tachycardia.

BabyLady, BSN, RN · Mar 28, 2009

I'm a student...but there was a mother, that walked in, perfectly healthy, young, calm, cool, collected...was having contractions, and they were getting closer together.

She was 36 weeks pregnant.

The physician ordered terbutaline to stop her contractions (sort of surprised me too). This mother was also a nurse, and she questioned the decision to stop them, and frankly, I'm surprised she agreed to the injection...but she did. However, I could tell that she was concerned.

We were sitting there talking to her, and suddenly she started rubbing her face..saying that she felt dizzy..the next thing she said is, "Something is wrong"....and she barely got out that she had this weak feeling that washed over her.

We called for assistance, put her on her left side, put in an IV, gave her 1000 mils of fluid...strapped on the fetal monitor...the FHR started to drop, her BP started to drop..but went back up fairly quickly.

Once we got her stable...she was fine...and her contractions resumed.

That blessed baby was just ready!

The charge nurse looked at me, smiled and said, "Well, I think we are done with the terbutaline for the day."

romantic, BSN, RN · Mar 28, 2009

I'm a student...but there was a mother, that walked in, perfectly healthy, young, calm, cool, collected...was having contractions, and they were getting closer together.
She was 36 weeks pregnant.
The physician ordered terbutaline to stop her contractions (sort of surprised me too). This mother was also a nurse, and she questioned the decision to stop them, and frankly, I'm surprised she agreed to the injection...but she did. However, I could tell that she was concerned.
We were sitting there talking to her, and suddenly she started rubbing her face..saying that she felt dizzy..the next thing she said is, "Something is wrong"....and she barely got out that she had this weak feeling that washed over her.
We called for assistance, put her on her left side, put in an IV, gave her 1000 mils of fluid...strapped on the fetal monitor...the FHR started to drop, her BP started to drop..but went back up fairly quickly.
Once we got her stable...she was fine...and her contractions resumed.
That blessed baby was just ready!
The charge nurse looked at me, smiled and said, "Well, I think we are done with the terbutaline for the day."

Thank you for sharing! it's a very interesting observation. You say heart rate was dropping... interesting.

Thanks!

SmilingBluEyes · Mar 29, 2009

Never have used terb to stop a true precipitous labor. I would hesitate to do so. If the baby is coming, she is coming. Can't stop that. And you want that uterus to contract well after the baby is here, so she does not bleed.

LM813 · Mar 29, 2009

The only time I have seen it done was for a 36 weeker, already PROM and GBS Postive so the MD wanted to get a dose of ABX in but I think it is contra-indicated after 35 weeks.

romantic, BSN, RN · Mar 29, 2009

Thank you all for your responses!

What are the first signs of precipitous labor?

Can you see the signs of tachysystole?

BabyLady, BSN, RN · Apr 8, 2009

Thank you for sharing! it's a very interesting observation. You say heart rate was dropping... interesting.
Thanks!

Yes, and as a student, that pretty much flipped me out because I couldn't believe the physician ordered it to start with.

Baby ended up being about 7 lbs too....either it was going to be a huge baby or that was just a missed due date.

morte, LPN, LVN · Apr 8, 2009

Yes, and as a student, that pretty much flipped me out because I couldn't believe the physician ordered it to start with.
Baby ended up being about 7 lbs too....either it was going to be a huge baby or that was just a missed due date.

40 weeks is a "mean", my mother was 2-3 weeks early with all three of us, and my sister in law was 2+ weeks late with two of hers, the third was induced......