This document discusses the evaluation and management of preterm labor. It outlines the key steps in history taking and physical examination for patients in preterm labor, including common symptoms and diagnostic tests. The document also reviews various medication options for treating preterm labor, including tocolytic medications and corticosteroids, as well as their potential benefits and risks. Fetal assessment is also recommended to monitor the fetus during preterm labor.

1. PRETERM LABOR

2. OBJECTIVES
- Evaluation of patients in preterm labor:
History taking
Physical examination for women in possible preterm labor
Diagnosis
- Management of preterm labor

3. HISTORY TAKING
1. Uterine cramping or contractions
2. Rhythmic low back pain
3. Pelvic pressure
4. Increased vaginal discharge
5. Vaginal bleeding (bloody show), which may result from
cervical dilation
Possible symptoms!

4. PHYSICAL EXAMINATIONS
Sterile speculum examination
Digital cervical examination
Urine culture
Fetal heart rate and uterine activity monitoring

5. Regular uterine contractions !!
Progressive cervical change !!
DIAGNOSIS
Cervical length ultrasound
positive predictive value of 55%
Fetal fibronectin
The positive predictive value of 25%

6. Case study

7. MANAGEMENT

8. BENEFITS?!
Tocolytic Medications
MEDICATIONS
RISKS?!
Magnesium Sulfate
Beta-Mimetics
Ritodrine , Terbutaline
Indomethacin
Ca-channel blockers
nifedipine

9. MEDICATIONS
BENEFITS?!
Adjunctive therapy
RISKS?!
Corticosteroids Antibiotics
Magnesium sulfate

10. FETAL ASSESSMENT
1. Ultrasound
- fetal weight
- Fetal presentation
2. Fetal well-being

11. REFERANCES

12. FINALLY.,’
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