Preterm Labor


The following is probably the most beneficial guidance to PTL that I have seen:

The purpose of obstetric management of preterm labor before 34 weeks gestation is to allow time to administer corticosteroids. Treatment does not substantially delay delivery beyond 1 week. Repeated administration of corticosteroids does not confer more benefit than a single course. Antibiotics are administered for prophylaxis of group B Streptococcus and are useful for delaying delivery if membranes are ruptured. They do not add any benefit otherwise, even though subclinical amnionitis may be a causative factor in many cases of preterm labor. Prolonged and repeated tocolysis is believed to be harmful. Tocolysis would not be indicated in this patient because she has had no cervical change and is therefore having preterm contractions, not preterm labor. Careful monitoring for fetal compromise, consultation with obstetric colleagues, and neonatal intensive-care unit involvement should be part of expectant management of preterm labor cases.  
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