A Maternal chorioamnionitis at barely viable gestations is unlikely to initiate labour.

[Feedback :- Below 26 weeks more than half show histological evidence of chorioamnionitis in the membranes.]

B Prolonged preterm rupture of membranes should be treated with oral erythromycin.

This is the Correct Answer

[Feedback :- The ORACLE trial showed a benefit from administration of oral antibiotics. Each case should be assessed on its merits, as if the mother has frank sepsis it may be safer to deliver the baby immediately.]

C If corticosteroids are given more than 72 hours before delivery, the beneficial effect on the baby's lungs is negligible.

[Feedback :- To be most beneficial, steroids should be given 24 hours before delivery, but their beneficial effect appears to last for a week or more.]

D If there is fetal distress at 25 weeks, the baby should be delivered by emergency lower segment caesarean section.

[Feedback :- Each case must be assessed individually and the risks to the baby and the mother must be balanced. At extreme gestations the lower segment of the uterus may not have developed, and so a classical (vertical incision) caesarean section may be required, which carries a worse prognosis for uterine rupture in the future.]

E Preterm delivery can often be prevented if preterm labour is ‘switched off’ by the use of tocolytics and bed rest.

[Feedback :- Tocolytics and bed rest can sometimes delay delivery for several days or more, allowing steroids to be administered, but these pregnancies rarely progress to full term.]