Obstetrics and Gynecology/Preterm Labour
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Pre-Term Labour [edit]
Definition [edit]
- Labour occurring between 20 and 37 weeks gestation.
Etiology [edit]
- 30% idiopathic
- 30% related to pre-labour rupture of membranes
- The rest related to a myriad of other factors
Management [edit]
Antibiotics [edit]
- Not-recommended for women in pre-term labour with intact membranes
Corticosteriods [edit]
- Corticosteriods (betamethasone) should be administered to promote fetal pulmonary development. However, multiple doses should be approached with caution.
Tocolysis [edit]
- Using atosiban, indomethacin, nifedipine
- Contraindications to tocolysis include
- Non-reassuring fetal status
- Dilated cervix >4cm
- Suspected intrauterine infection
- Gestational age >34 weeks or <23 weeks
- Intrauterine fetal death
- Fetal anomaly incompatible with life
- Maternal deterioration necessitating delivery
Pre-Labour Rupture of the Membranes [edit]
Definition [edit]
- Pre-labor rupture of the membranes (PROM) may occur at pre-term or term dates. PROM poses a significant risk for pre-term labour.
Epidemiology [edit]
- PROM occurs in less than 30% of pregnancies.
Management [edit]
- Antibiotics will prolong the latent phase of labour, prevent/treat ascending infection, and reduce the incidence of complications with prematurity.
