Steroids
- ›Betamethasone 12 mg IM, 2 doses 24 h apart (or dexamethasone 6 mg IM × 4 doses q12h).
- ›Offer 24⁺⁰–33⁺⁶ / 34⁺⁰–35⁺⁶ if imminent birth.
- ›Rescue dose if >7 days since first course and imminent birth <34/40.
Tocolysis
- ›Nifedipine 20 mg PO stat → 10–20 mg TDS-QDS (first line, max 48 h).
- ›Atosiban if nifedipine contraindicated.
- ›Purpose: gain 48 h for steroids + in-utero transfer — not to prolong pregnancy.
Magnesium for neuroprotection
- ›MgSO₄ 4 g IV over 20 min → 1 g/h if delivery expected <30/40 within 24 h.
Common mistakes
- •Giving tocolysis to buy time when maternal/fetal indications for delivery exist.
- •Forgetting MgSO₄ neuroprotection <30/40.
- •Betamethasone in uncontrolled infection or diabetes without insulin adjustment.