Obstetrics and Gynecology/Preterm 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

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

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.