Preterm Labor

  • If between 24.0-34.0 wks, initiate tocolysis with either magnesium sulfate or nifedipine (see order sheet for details). Tocolysis might also be used up to 35-36 wks to stabilize for transport.
  • No strong preference for either tocolytic. Nifedipine has more efficacy data to support its use. MgSO4 has neuroprotective properties for the preterm infant
  • Cannot overlap these 2 medications—there have been reports of dangerous cardiac events. No MgSO4 for at least 6 hours after last nifedipine dose.
  • Base your choice of agent on maternal situation, vital signs, and underlying medical conditions, as well as anticipated benefit of neuroprophylaxis for infant (i.e., earlier gestational ages, favor MgSO4)
  • Begin betamethasone and begin GBS prophylaxis unless recent (within 5 wks) culture negative
  • FFN mainly useful as a way to decide who most warrants treatment and transfer. Once a patient is deemed requiring transfer, it is less useful, but may aid us in long term planning.
  • Terbutaline is best avoided (maternal side effects have led to FDA black box warning)
  • Refer to PTL/Tocolysis order set if needed

Contact Information

MinistryConnect:

1.888.411.1362

Ministry Saint Joseph's Hospital Birth Center:

715.387.7071

Ministry Saint Joseph's Hospital NICU:

715.387.7083

 
 
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