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  • 4 Flow Chart Preterm

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    Yeni Puspita
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    Preterm labor is defined as the onset of labor between 20 and 37 weeks of gestation. Management of preterm labor involves bed rest, IV fluids, tocolytic medications to stop contractions, antibiotics to prevent infection, and corticosteroids to promote fetal lung maturation if delivery is likely before 34 weeks. Patients can be discharged if contractions have stopped for 48 hours and symptoms that prompted admission have resolved, with education on monitoring for signs of preterm labor.

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    Preterm labor is defined as the onset of labor between 20 and 37 weeks of gestation. Management of preterm labor involves bed rest, IV fluids, tocolytic medications to stop contractions, antibiotics to prevent infection, and corticosteroids to promote fetal lung maturation if delivery is likely before 34 weeks. Patients can be discharged if contractions have stopped for 48 hours and symptoms that prompted admission have resolved, with education on monitoring for signs of preterm labor.

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    213 views4 pages

    4 Flow Chart Preterm

    Uploaded by

    Yeni Puspita
    Preterm labor is defined as the onset of labor between 20 and 37 weeks of gestation. Management of preterm labor involves bed rest, IV fluids, tocolytic medications to stop contractions, antibiotics to prevent infection, and corticosteroids to promote fetal lung maturation if delivery is likely before 34 weeks. Patients can be discharged if contractions have stopped for 48 hours and symptoms that prompted admission have resolved, with education on monitoring for signs of preterm labor.

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    of 4

    Preterm Labor

    Preterm Labor

    1 Definition

    Preterm labor is defined as the onset of labor (regular uterine contractions


    associated with cervical changes) occurring after 20 weeks and before 37
    completed weeks of gestation.

    2 Clinical Picture
    3 Contraindications of Tocolytic Therapy

    4 Preterm Delivery

    5 Conservative Management
    Admit the patient to the labor ward and put her on complete bed rest.
    Insert an IV cannula.
    Tocolysis
    β- sympathomimetic agents, e.g., ritodrine (Yutopar)
    Terbutaline (Bricanyl)
    Calcium channel blockers (nifedipine)
    Magnesium sulfate
    Prostaglandin synthetase inhibitors
    There is no evidence to support the use of oral tocolysis; e.g., the maintenance
    treatment is not recommended for routine practice.
    Antibiotics
    It is reasonable to use prophylactic antibiotics in women with preterm labor
    in an attempt to prevent the progression of silent infection to clinical
    amnionitis and the risk of fetal infection.
    Corticosteroids
    Dexamethasone IM 4 mg/6 hours for 4 doses or betamethasone IM 12 mg/12
    hours for 2 doses to promote fetal lung maturation for pregnancies less
    than 34 weeks
    Observations
    Vital signs every 30 minutes for two hours; if normal, then per routine
    Blood pressure should not be  100/60 mmHg
    Maternal pulse no higher than 120/bpm
    Vaginal discharge or bleeding
    No uterine contractions more than 6/hour
    Urinary output of  30 cc/hour or  100 cc/4 hours
    Ultrasound, NST twice weekly
    Consultations according to associated problems
    Monitor intake of all medications

    6 Conditions for Discharge


    At least 48 hours have passed since tocolysis was achieved and the symptoms
    and signs that motivated the admission have resolved. General examination
    should reveal that the woman is in good condition.
    No associated pathology and not under treatment (e.g., antibiotics)
    Educate the patient on the following topics:
    Monitoring uterine activity
    Counting fetal movements and watch for decreased movement
    Stopping sexual activity
    Evaluating vaginal discharge
    Evaluating vaginal bleeding
    Decreasing physical activity
    Understanding the necessity of delivering in a hospital
    Understanding the importance of correctly complying with medical treatment
    and prenatal care

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