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.