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4 Flow Chart Preterm
4 Flow Chart Preterm
Preterm Labor
1 Definition
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