Terbutaline-Induced Lactic Acidosis in a Pregnant Patient with Preterm Labor: A Case Report and Literature Review

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Published: Mar 18, 2025
Keywords:
acidemia pregnancy bronchodilator metabolic acidosis wide-gap metabolic acidosis

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Krit Tipchaichatta
Division of Nephrology, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Naowanit Nata
Division of Nephrology, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand

Abstract

Preterm labor, defined as regular uterine contractions with cervical changes occurring between 20+0/7 and 36+6/7 weeks of gestation, is a significant cause of perinatal morbidity and mortality. Before 34 weeks of gestation, corticosteroids are administered to enhance fetal lung maturity. Tocolytic agents, such as calcium-channel blockers and beta-adrenergic receptor agonists, are used to delay labor, allowing time for corticosteroid efficacy. This case report describes a pregnant patient with preterm labor treated with terbutaline, a beta-adrenergic receptor agonist. During treatment, the patient developed metabolic acidosis, which laboratory tests confirmed was due to terbutaline-induced lactic acidosis. The condition resolved after discontinuing terbutaline. Terbutaline-induced lactic acidosis requires careful exclusion of other causes and typically resolves spontaneously once the drug is stopped. Studies suggest terbutaline may increase glycolysis, leading to elevated pyruvate and lactate levels.

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How to Cite
Tipchaichatta, K. ., & Nata, N. (2025). Terbutaline-Induced Lactic Acidosis in a Pregnant Patient with Preterm Labor: A Case Report and Literature Review. Journal of the Nephrology Society of Thailand, 31(1), 85–93. retrieved from https://he01.tci-thaijo.org/index.php/JNST/article/view/275947
Issue
Vol. 31 No. 1 (2025): January - March
Section
Case Report
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