A client in preterm labor at 31 weeks is dilated to 4 cm and has been started on magnesium sulfate; contractions stop. If labor is inhibited for 48 hours, which medication is likely prescribed?

A client in preterm labor at 31 weeks is dilated to 4 cm and has been started on magnesium sulfate; contractions stop. If labor is inhibited for 48 hours, which medication is likely prescribed?

• A. Nalbuphine
• B. Betamethasone
• C. Rho(D) immune globulin
• D. Dinoprostone vaginal insert

Answer: (B)

When preterm birth is likely, giving antenatal corticosteroids to the mother helps accelerate fetal lung maturity. Betamethasone is used between about 24 and 34 weeks of gestation for this purpose and is given in two intramuscular doses about 24 hours apart. In this scenario, labor has been inhibited for 48 hours, providing the window to complete that steroid course, which improves the baby’s surfactant production and reduces risks like respiratory distress syndrome after birth. Magnesium sulfate is already used for neuroprotection in very preterm infants, but the next key medication to optimize neonatal outcomes is the corticosteroid. The other options don’t fit this goal: nalbuphine is for analgesia, not to enhance lung maturity; a dinoprostone vaginal insert would promote labor rather than delay it; and Rho(D) immune globulin is given for Rh incompatibility issues, not routine management of imminent preterm birth.

When preterm birth is likely, giving antenatal corticosteroids to the mother helps accelerate fetal lung maturity. Betamethasone is used between about 24 and 34 weeks of gestation for this purpose and is given in two intramuscular doses about 24 hours apart. In this scenario, labor has been inhibited for 48 hours, providing the window to complete that steroid course, which improves the baby’s surfactant production and reduces risks like respiratory distress syndrome after birth. Magnesium sulfate is already used for neuroprotection in very preterm infants, but the next key medication to optimize neonatal outcomes is the corticosteroid.

The other options don’t fit this goal: nalbuphine is for analgesia, not to enhance lung maturity; a dinoprostone vaginal insert would promote labor rather than delay it; and Rho(D) immune globulin is given for Rh incompatibility issues, not routine management of imminent preterm birth.