Procedure Ready: Ob/Gyn

Preterm Labor and PPROM


Listen Later

ACOG Practice bulletin: # 171

PTL or TPTL:  Preterm <37wks, cervical change

Evaluation:

SSE first: Collect GC/CT cultures, FFN (no gel, blood or semen), GBS, eval for rupture if needed

SVE:

Cervical change–can dilation or effacement changes

FFN: Fetal fibronectin

If tPTL:

  • Magnesium for neuroprotection if <32wks, decrease CP rates
  • Betamethasone for fetal lung development
  • PCN
  • Tocolysis for steroid window (48hrs) if <34wks, questionable if 34-36+6. Indocin if <32 wks, Nifidipine if 32+wks
  • IV fluids
  • NICU consult
  • PPROM: Preterm <37wks, Ruptured membranes

    SSE: Confirm rupture with Pooling, nitrazine ferning. Collect GC/CT and GBS.

    If PPROM: Delivery at 34wks or at diagnosis if chorio or 34+wks

    • Latency antibiotics: Erythromycin/Azithromycin, Ampicillin x 2 days, PO Erythro/Amoxicillin x 5 days
    • Magnesium for neuroprotection if <32wks, decrease CP rates
    • Betamethasone for fetal lung development
    • PCN
    • NO Tocolysis
    • NICU consult
    • ...more
      View all episodesView all episodes
      Download on the App Store

      Procedure Ready: Ob/GynBy Jennifer Doorey, MD, MS

      • 4.9
      • 4.9
      • 4.9
      • 4.9
      • 4.9

      4.9

      268 ratings


      More shows like Procedure Ready: Ob/Gyn

      View all
      Sword and Scale by Sword and Scale

      Sword and Scale

      62,630 Listeners

      The Curbsiders Internal Medicine Podcast by The Curbsiders Internal Medicine Podcast

      The Curbsiders Internal Medicine Podcast

      3,360 Listeners

      The Daily by The New York Times

      The Daily

      112,426 Listeners

      Up First from NPR by NPR

      Up First from NPR

      56,545 Listeners

      Where Should We Begin? with Esther Perel by Esther Perel Global Media

      Where Should We Begin? with Esther Perel

      14,937 Listeners

      Call Her Daddy by Alex Cooper

      Call Her Daddy

      165,404 Listeners

      CREOGs Over Coffee by CREOGs Over Coffee

      CREOGs Over Coffee

      553 Listeners

      As a Woman by Natalie Crawford, MD

      As a Woman

      1,107 Listeners

      Spoonful of Sugar by Ria Mulherkar

      Spoonful of Sugar

      72 Listeners

      The Ezra Klein Show by New York Times Opinion

      The Ezra Klein Show

      15,948 Listeners

      Two Hot Takes by Morgan Absher

      Two Hot Takes

      7,903 Listeners

      Clerkship Ready: Pediatrics by MedReady

      Clerkship Ready: Pediatrics

      23 Listeners

      Good Hang with Amy Poehler by The Ringer

      Good Hang with Amy Poehler

      10,586 Listeners