At what gestation do you stop treating PTL?

  1. I'm curious - in your hospitals, at what gestation do the docs stop being aggressive with preterm labor? I have found this to vary quite a bit in the different places I have worked. At one place (a mid-size level 2 OB with a level 3 NICU), 36 weeks was the cutoff for treatment. At another (a small level 1), it was anywhere from 35-37 depending on the doctor. At the place I'm at now (a large teaching hospital with a major NICU) they USUALLY don't start mag on anyone after 34 weeks, although they will try less aggressive measures such as bedrest, IV hydration, and some will use po meds.

    What is your experience?
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    About rn500

    Joined: Sep '00; Posts: 86; Likes: 80
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    10 Comments

  3. by   SmilingBluEyes
    usually 36-37 weeks both places I work.
  4. by   L&D.RN
    None of the docs at my hosp will do anything if the pt is 36 weeks, but some will let 35 point somethings go without stopping labor.
  5. by   nograd
    Where I am at now a level 2+ community hospital we will treat with mag up to 34 weeks and turb up to 36-37 weeks dependant on the MD and patient's condition. My own personal experience had me on turb po until 37 weeks...of course I went post dates...ya never know.
  6. by   mother/babyRN
    36 weeks usually.
  7. by   Anagray
    36 weeks, sometimes 35 -34, but I think it also depends on a patient. I know some women, who were on bed rest earlier on for PTL, had agressive treatmenet, steroid shots, etc If the baby is large enough, they would deliver before 36 weeks, if she went into labour again before the cut off date.
  8. by   moonshadeau
    Now I am not an OB nurse but I can tell you that in my situation they told me that they want me to make it at least another week to 34 weeks. At the 34 week cut off point they deliver at my hospital and will not ship me to mother Mayo. We'll see if I make it or not.
  9. by   SmilingBluEyes
    34 weeks is extremely problematic, in my personal and professional experience. Born at 34 weeks, My son would not breathe on his own at first and once he did, he had to have supplemental o2 and bili lights as well as ABX TX. They may not ship YOU at 34 weeks' gestation, but baby may be shipped, if sick.
  10. by   nimbex
    well difference is WHEN the problems started and what treatment has been initiated. having problems with all 3 kids, I consider myself the unofficial expert.

    Kid one, PIH, pictocin at 36 weeks due to high protein, high BP and pending acute renal failure.

    kid two, low amniotic fluid with 3x's a week fetal monitoring which resulted in decels every time the baby was stimulated, estimated at 4 lbs. was induced at 36 weeks at 6lbs. was high risk for sids, had home monitor and a a few close calls with 911 and home health visits for sids prevention, but by the grace of god she made it.

    son, #3 kid, at 27 weeks was done, cervix dialated at 4 cm's, went into labor, started on mag drip. Couldn't suture cervix due to some reason. Was on bed rest with the 18 month old holter monitor gal, 18 month old and bed rest, yeah....would walk to the bathroom and go into labor, drink a gallon of water, labor subsided, after resting and sending into monitoring...and arguing the need to go inpatient, with 2 kids at home, contractions comming... geeze.


    Spent july 5th through August 18th admitted for weeks at a time on a mag drip, SSOOOO sick from it, kids at home but one to be born yet.

    for 6 plus weeks took albuterol plus prednisone to grow the lungs and relax the uterus. this worked until 33 weeks when water broke and my son was born,,,,, BREATHING with developed lungs, no sucking reflex, but hey, he was alive and well. took 45 minutes to feed him every two hours,,, during nursing school.

    failed to thrive for 6 weeks, did fair at home, was short, slow and sick for 2 whole years, then out grew it!!!!

    Ben is 9, he is sooooooo sharp !!! he is finally growing out of his clothes both width and length.

    so I share this because after my sids survival daughter nicole, they told me no more kids. Had one more, at 33 weeks, they all but gave up on his chances but the mag,,,,, pure hell, all summer long in and out of the hospital saved him.

    So from experience, they would have let me go to 36 weeks before stopping mag and letting labor continue. That's' all I heard was you'll see your son at 36 weeks not before. Water breaking created a "must do", which thank GOD for me led to a good outcome, after many stressful months.

    I went to a specialized high risk childrens hospital and this was their norm, which gave me three beautiful, healthy children...... Although who at times I could be bribed to sell them :roll
    Last edit by nimbex on May 23, '03
  11. by   dawngloves
    Thread Highjack!
    Longest you've even had a PROM pt? When did they rupture and when did they deliver?
  12. by   NurseyNursey
    I work at a small, rural hospital. We do about 30 deliveries in a busy month. Level I nursery. We try not to deliver anything before 37 weeks. Nearest NICU is over an hour away.

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