Management of premature labour in diabetic pregnancy.
The practical management of premature labour is described, illustrated by ten cases. All the patients were treated with beta-sympathomimetic infusion, either salbutamol (0.4-1.6 mg/h) or ritodrine hydrochloride (2-6 mg/h), to stop uterine contractions, and with intramuscular dexamethasone 4 mg eight hourly to accelerate foetal lung maturity. Satisfactory control of blood glucose was achieved (range 2-10 mmol/l) by using high rates of insulin infusion (range 8-32 units per hour). Delivery was postponed in eight cases and seven healthy babies were born. There were three foetal deaths from multiple congenital abnormalities. Beta-sympathomimetic infusion caused few maternal side-effects and there were no foetal problems. Maternal plasma potassium decreased in all cases studied, the mean fall being from 4.5 mmol/l to 2.7 mmol/l.
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000420:Albuterol / Q000627:therapeutic use; D001786:Blood Glucose; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007328:Insulin / Q000008:administration & dosage; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000628:therapy*; D012312:Ritodrine / Q000627:therapeutic use; D014590:Uterine Contraction / Q000187:drug effects
D000318:Adrenergic beta-Agonists; D001786:Blood Glucose; D007328:Insulin; D003907:Dexamethasone; D012312:Ritodrine; D000420:Albuterol