PREMATURE LABOUR

PREMATURE CONTRACTIONS

  • Bed rest in left lateral position
  • Salbutamol
    • Tablets 4 mg four times daily
  • Nifedipine
    • Initial dose of 20mg
    • Followed by three further doses of 20mg every 30 minutes
      • As long as contractions continue
    • Maintenance dose is 20-40mg orally every 4 hours for 48 hours
      • No more than 160mg/24 hours
  • Potent corticosteroids
    • Accelerates lung maturity of fetus
      • Betamethasone 1 ampule i.m. 2 doses 12 hours apart
      • Dexamethasone 6 mg i.m. 4 doses 12 hours apart

INSUFFICIENT CERVIX

  • Cerclage with heavy non-resorbable suture
  • Remove suture when contractions start
    • Or deliver by C/S

PREMATURE DELIVERY

  • Maintain body temperature
    • Incubator is questionable high tech
    • Kangaroo method is more appropriate technology
      • No significant difference in survival rate between the two methods
    • Cover head
  • Feed with breast milk
    • Cup
    • Spoon
    • Gastric tube

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