A 34 weeks pregnant female presented with uterine contractions, with no other risk factors. Next immediate step in management is?
Expectant management REF: Current OB/GYN 2009 edition Chapter 15. Preterm Labor: Essentials of Diagnosis Estimated gestational age of greater than 20 weeks and less than 37 weeks. Regular uterine contractions at frequent intervals. Documented cervical change or appreciable cervical dilatation or effacement (at least 2 cm dilated without previous examination). Management: Tocolytic agents and steroids are used in management of pregnancies with preterm labor between 24 and 34 weeks' gestation or EFW 600-2500 g. Once a pregnancy has continued beyond 34-37 weeks' EGA or EFW greater than 2500 g, the fetal survival rate is within 1% of the survival rate at 37 weeks. Fetal morbidity is less severe and is rarely a cause of long-term sequelae. Fuhermore, coicosteroids have not been shown to be of benefit in fetuses of this age or size. Therefore, expectant management is usually the recommended course of action
Tocolytic for 3 more weeks
Dexamethasone should be given
Vacuum assisted delivery
Expectant management