From the Research
The primary treatment for a pregnant woman experiencing preterm labor is tocolytic therapy to temporarily stop contractions, combined with corticosteroids to accelerate fetal lung maturity.
Tocolytic Therapy
Common tocolytics include nifedipine (10-20mg orally every 4-6 hours), indomethacin (50-100mg loading dose followed by 25-50mg every 6 hours for up to 48 hours), or magnesium sulfate (4-6g IV loading dose followed by 1-4g/hour maintenance) 1.
Corticosteroids
Corticosteroids, typically betamethasone (12mg IM, two doses 24 hours apart) or dexamethasone (6mg IM, four doses 12 hours apart), should be administered between 24-34 weeks gestation 2.
Additional Measures
Magnesium sulfate may also be given for neuroprotection if delivery is imminent before 32 weeks.
- Antibiotics are indicated if there is evidence of infection or if membranes have ruptured.
- Bed rest, hydration, and continuous monitoring of maternal and fetal status are essential supportive measures. The goal is to delay delivery long enough to administer corticosteroids and, if necessary, transfer the patient to a facility with appropriate neonatal care capabilities, as premature birth can lead to significant complications for the newborn 1, 2.
Key Considerations
- The use of tocolytic agents should be individualized and based on maternal condition, potential side effects, and gestational age 3.
- Nifedipine may be a reasonable first choice because it is easy to administer and has limited side effects relative to β2-mimetics 1.
- Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes 2.