TREATMENT OF TERBUTALINE RASH IN PREGNANCY
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I have a young woman pregnant with twins (IVF) (week 28) who was 
hospitalized for the treatment of premature labor 16 days
ago.  Her premature contractions were controlled with 
Magnesium sulfate.  She was successfully converted to a 
terbutaline infusion which gave adequate tocolysis.  On
day 9 after having started the terbutaline the patient 
developed a pruritic morbilliform exanthem, most pronounced 
in the left anterior thigh in the region of the infusion
pump.  

I diagnosed a hypersensitivity reaction to the terbutaline.
While I recommended that the medication be discontinued. If
tocolysis can't be achieved with alternative agents, how 
does one manage the risk of treating through a drug eruption 
during pregnancy?  I would like to draw on the group's 
experience.

Rhett Drugge, M.D. 
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Could one safely smash it with prednisone (dexamthasone, H.E.)? Might she
have a preservative sensitivity? What is the preservative in I.V.
Terbutaline? 

Diane Thaler
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ITS A RISK/BENEFIT PROBLEM 

If she really needs the terbutaline, I would continue it.  However, it seems
to me that only the gynecology literature has more unproven anecdote than the
derm literature.

Rick Sharpe
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Agreed! Think of all of the labors supposedly stopped by I.V. ethanol, and
all of the fetal alcohol syndrome children produced. We could always put
the chronic urticaria patients at complete bedrest..

Diane Thaler
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