< Obstetrics and Gynecology

Pre-Term Labour

Definition

  • Labour occurring between 20 and 37 weeks gestation.

Etiology

  • 30% idiopathic
  • 30% related to pre-labour rupture of membranes
  • The rest related to a myriad of other factors

Management

Antibiotics

  • Not-recommended for women in pre-term labour with intact membranes

Corticosteroids

  • Corticosteroids (betamethasone) should be administered to promote fetal pulmonary development. However, multiple doses should be approached with caution.

Tocolysis

  • 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

Definition

  • 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

  • PROM occurs in less than 30% of pregnancies.

Management

  • Antibiotics will prolong the latent phase of labour, prevent/treat ascending infection, and reduce the incidence of complications with prematurity.
This article is issued from Wikibooks. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.