Obstetrics and Gynecology/Preterm Labour
Pre-Term Labour
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Definition
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Labour occurring between 20 and 37 weeks gestation. Etiology
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30% idiopathic
30% related to pre-labour rupture of membranes
The rest related to a myriad of other factors Management
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Antibiotics
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Not-recommended for women in pre-term labour with intact membranes Corticosteroids
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Corticosteroids (betamethasone) should be administered to promote fetal pulmonary development. However, multiple doses should be approached with caution. Tocolysis
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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
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Definition
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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
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PROM occurs in less than 30% of pregnancies. Management
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Antibiotics will prolong the latent phase of labour, prevent/treat ascending infection, and reduce the incidence of complications with prematurity.