Threatened preterm labor
Women presenting with threatened preterm labor are often treated with:
- Hospitalisation in a unit with facilities for neonatal intensive care.
- Administration of tocolytics to prevent preterm birth.
- Administration of steroids to improve fetal lung maturity.
Randomised studies on the use of tocolytics in threatened preterm labour have demonstrated a significant prolongation of pregnancy by about seven days but no significant reduction in the incidence of preterm birth. Consequently, the primary aim of tocolysis is to achieve prolongation of pregnancy for a couple of days for effective treatment with steroids for fetal lung maturity, rather than prevention of preterm birth as such.
Management of threatened preterm labor
Distinguish between true and false labor:
- Cervical length
- Cervicovaginal fetal fibronectin
In those with true labor:
- Tocolytics to delay delivery
- Steroids to mature fetal lungs