Please select the eligibility criteria that correspond to the clinical trial below.
Title: Tocolysis in the Management of Preterm Premature Rupture of Membranes Before 34 Weeks of Gestation: a Double-blinded Randomized Controlled Trial
Brief Summary: The purpose of this study is to assess whether short-term (48 hr) tocolysis reduces perinatal morti-morbidity in cases of PPROM at 22 to 33 completed weeks' gestation.


Options:
A: Inclusion Criteria:

* Gestational age between 24 0/7 - 31 5/7 weeks by LMP or ultrasound
* Documentation of rupture by demonstrating pooling or 2/3 diagnostic tests (pooling, ferning and nitrazine positivity)

Exclusion Criteria:

* Membrane rupture greater than 72 hours
* Persistent labor characterized by regular painful contractions with cervical change and/or cervix visually greater than 5 cm
* Chorioamnionitis defined by having 2 or more of the following: maternal temperature \> 100.4, persistent fetal tachycardia (\>170bpm), maternal tachycardia (\>110bpm) in the absence of other likely cause, uterine tenderness.
* Non-reassuring fetal heart rate tracing or biophysical testing
* Vaginal hemorrhage
* Lethal fetal anomalies
* Intrauterine fetal demise
* Maternal conditions which precludes expectant management
* Fetal condition which precludes expectant management
* Maternal allergy to indomethacin
* Maternal active gastritis
* Multiple gestations
* HIV with viral load \>1000
* HSV with active herpetic lesions
* Cervical cerclage
B: Inclusion Criteria:

• Singleton pregnancy women between 22 and 34 weeks of gestation who presented with threatened preterm labor.

Exclusion Criteria:

* Multiple pregnancies
* Women with Preterm Prelabour Rupture of Membrane
* Fetal death
* Women with bad obstetric history
* Women with history of cervical incompetence
* Contraindication to Nifedipine such as cardiovascular disease, hyperthyroidism, severe pre eclampsia or to Utrogestan
* Maternal or fetal indication for immediate delivery, such as fetal distress, bleeding placenta previa, abruption placenta
* Contraindication for tocolysis, for example severe pre eclampsia, intrauterine growth restriction, fetal anomaly, chorioamnionitis, significant antepartum haemorrhage
* Cervical dilatation of 3cm or more
* Patients with previous tocolytic treatment during this pregnancy
* Women who refuse to participate in this study
C: Inclusion Criteria:

* Women in preterm labor between 24 to 32 6/7 weeks' gestation with intact membranes with an age range of 15 to 50 years old.

Exclusion Criteria:

* Cervical dilatation of ≥ 6 cm
* Maternal contraindication to tocolysis
* Known fetal anomalies
* Suspected chorioamnionitis
* Nonreassuring fetal heart tracing
* Vaginal bleeding due to placenta previa or abruptio placenta
* Preterm premature rupture of membranes
* Prolapsed membranes
* Human immunodeficiency virus positive
* Multiple gestation
* Patients on procardia within 24 hours of po intake
* Magnesium sulfate tocolysis prior to randomization
* Patient refusal
D: Inclusion Criteria:

* Preterm premature rupture of membranes (PPROM) between 220/7 - 336/7 weeks of gestation, as diagnosed by obstetric team
* Singleton gestation
* Fetus alive at the time of randomization (reassuring fetal heart monitoring)
* 18 years of age or older
* French speaking
* Affiliated to social security regime or an equivalent system
* Informed consent and signed

Exclusion Criteria:

* PPROM ≥ 24 hours before diagnosis
* Ongoing tocolytic treatment at the time of PPROM
* Tocolytic treatment with Nifedipine between PPROM diagnosis and randomization
* Fetal condition contraindicating expectant management including chorioamnionitis, placental abruption, intrauterine fetal demise, non-reassuring fetal heart rate at the time of randomization
* Cervical dilation \> 5 cm
* Iatrogenic rupture caused by amniocentesis or trophoblast biopsy
* Major fetal anomaly
* Maternal allergy or contra-indication to Nifedipine or placebo drug components\*:

  * Myocardial infarction
  * Unstable angina pectoris
  * Hepatic insufficiency
  * Cardiovascular shock
  * Beta blockers

placebo drug components: lactose monohydrate, colloidal silica, microcrystalline cellulose

* Coadministration of diltiazem or rifampicin
* Hypotension (systolic pressure \< 90 mmHg)
* Participation to another interventional research (category 1) in which intervention could interfere with TOCOPROM's results (efficacy and safety)

Answer: D