Preterm labour

Summary of changes

  • This protocol has incorporated 'Stopping labour (tocolysis)' and ‘preventing preterm birth’ protocols from the previous edition

Addition

  • Check for and section on cervical stitch, includes tocolysis and section on preterm labour with cerclage

Medicines 

  • Clarification re use nifedipine IR only and administration regimen
  • Further nifedipine IR dose every 3-6 hours up to 48 hours (was every 6 hours for 24 hours)

Primary references

  1. Berghella V, Ciardulli A, Rust OA, To M, Otsuki K, Althuisius S, Nicolaides KH, Roman A and Saccone G (2017) 'Cerclage for sonographic short cervix in singleton gestations without prior spontaneous preterm birth: systematic review and meta-analysis of randomized controlled trials using individual patient-level data', Ultrasound in Obstetrics & Gynecology, 50(5):569-577, doi:10.1002/uog.17457

  2. Buckley N (Editor) (2021) Nifedipine (obstetric), Australian Medicines Handbook, AMH Pty Ltd, Adelaide, accessed 11 July 2021.

  3. Flenady V, Wojcieszek AM, Papatsonis DN, Stock OM, Murray L, Jardine LA and Carbonne B (2014) 'Calcium channel blockers for inhibiting preterm labour and birth', Cochrane Database of Systemic Reviews, 5(6):CD002255, doi:10.1002/14651858.CD002255.pub2

  4. National Institute for Health and Care Excellence (2019) Preterm labour and birth [NG25], NICE Clinical Guidelines, accessed 11 January 2022.

  5. Queensland Clinical Guidelines (2020) Preterm labour and birth, Maternal and Neonatal Clinical Guideline, accessed 18 September 2022.

  6. Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2017) Measurement of cervical length in pregnancy for prediction of preterm birth (Statement C-Obs 27), accessed 18 September 2022.

  7. Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2017) Progesterone: Use in the Second and Third Trimester of Pregnancy for the Prevention of Preterm Birth (Statement C-Obs 29), accessed 18 September 2022.

  8. South Australian Maternal, Neonatal and Gynaecology Community of Practice (2021) Preterm Labour & Birth, Prevention, Diagnosis & Management, SA Perinatal Practice Guidelines, accessed 18 September 2022.