| If labor begins prior to 37 weeks gestation, this is termed preterm labor. The patient will present with a constant low back pain, cramping, and painful contractions in the setting of cervical change at less than 37 weeks gestation.
Laboratory studies that should be obtained include cultures of the urine, vagina, and cervix, which are performed to detect infection. An ultrasound can determine the volume of amniotic fluid, and assess fetal well-being.
If the gestation is less than 34 weeks, then tocolytic therapy with magnesium sulfate or terbutaline, indomethacin, or nifedipine, should be given for 24 hours, while glucocorticoids such as betamethasone or dexamethasone are administered for 48 hours to aid in enhancing lung maturity. Even in the case of preterm premature rupture of membranes, with its potential for infection, expectant management is advised. The patient should be hospitalized, with activity restricted and an emphasis placed upon hydration. |