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* Tocolysis and magnesium sulfate
  kolokiko - 03/02/18 22:59
  I was reading master the boards.
It says for premature rupture of membranes do not give tocolysis.
It also. Says in pts less than 32wks observe, for 32 to 34 give betamethas and antibiotics, and for more than 34 initiate delivery

When I was doing uw, I remember it says, if less than 32 give mag sulfate, if between 32 to 34 then antib, dex and mag
Can someone clarify the need for magnesium, and what is the need for it, since we are not allowed to give tocolysis?

Also finally can someone tell me when to give tocolysis generally in obs, and what are the medications used?

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* Re:Tocolysis and magnesium sulfate
  cardio69 - 03/03/18 03:42
  Previable/less than 24wks-> watchful waiting/bed rest (no tocolytics/steroid/MgSO4, nor abx) you may do induction of labor -> to end pregnancy.

Preterm as you ask 24-33wks pickier 23/07-33 6/7 -> tocolytic prevent labor; steroid 2x 24hr apart to mature the lung and MgSO4* as tocolytic if its above 32/I think uw said it btw32-34 then its correct (less than 32wk possible cerebral palsy in the kido) while lung mature & abx/ampi or erthyro for GBS prevention/mom & strep if the baby will walk to world norm/vaginally. Amnioinfusion/replace the parish fluid is controversial.

Now, I must say I think current tocolytics* in preterm/PROM differs btw specialists. However, no concert improvement noted in kido outcome by tocolytics so -> no tocolysis. Again MgSO4/mimeticB/indomethanin or CCB in gray area relativity.

Now, let say you antenatal adm corticosteroid & abx & transfer the pat to appropriate neonatal center then I think that allowed.

Late preterm 34-36 -> induce labor/oxy/PG, (otherwise ->CS), abx for GBS prevention as above.

Term above 37 -> induce labor, again abx for GBS prev.

If you want post Uw q here. I can see it

My 2 cents.
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* Re:Tocolysis and magnesium sulfate
  kolokiko - 03/03/18 19:32
thank you much
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* Re:Tocolysis and magnesium sulfate
  cardio69 - 03/06/18 14:53
  Glad I could help.  
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