Obstetric pain history

Question 1

Differentials

Answer 1

Labour (inc. premature labour)
Placental abruption
Uterine rupture
Chorioamnionitis (infection)
Braxton Hixks contractions
Renal colic

Question 2

Management of premature labour

Answer 2

Tocolysis with nifedipine: nifedipine is a calcium channel blocker that suppresses labour

Maternal corticosteroids: can be offered before 35 weeks gestation to reduce neonatal morbidity and mortality

IV Magnesium sulphate: can be offered before 34 weeks gestation and helps protect the baby’s brain

Cervical cerclage