Management of Asthma during Pregnancy

To the Editor: Greenberger and Patterson's review of the physiologic basis of the treatment of asthma during pregnancy (April 4 issue)¹ contains several errors that require comment. Their statement that subcutaneous epinephrine is the treatment of choice for acute asthma during pregnancy is incorrect. Studies linking epinephrine to congenital malformations and decreased uterine blood flow² should make one more cautious. Although the effects of the new beta₂-agonists need to be monitored carefully, terbutaline has not been implicated as a teratogen,³ does not adversely affect uterine blood flow,⁴ and is a better choice. Although the authors note correctly that.