Obstetrics and Gynecology/Preterm Labour

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.