191- abnormal pregnancy

Question 1

two main causes of preterm labor

Answer 1

infection/inflammation, excessive uterine stretch

Question 2

what is the only therapy with proven clinical benefit for preterm labor? what else do we use?

Answer 2

antenatal corticosteroids. Tocolytics like terbutyline can help for 48 hours

Question 3

cervical insufficiency: what is it? how can we manage it?

Answer 3

cervical dilation w/ no contractions (usually 2 trimester). Cerclage (suturing cervix)

Question 4

PPROM: what is it? how is ti diagnosed? when do you deliver?

Answer 4

preterm premature rupture of membranes (same as PROM but before 37 wks). Rupture before labor starts. Speculum exam with microscopic “ferning” pattern. If <34 wks give steroids and antibiotics. If 34 wks just deliver

Question 5

what are some iatrogenic causes of preterm birth

Answer 5

placenta previa (planned c-section @ 37 wks), vasa previa (fetal blood hemorrhage), placental abruption, fetal growth restriction, severe preeclampsia, Rh alloimmunization

Question 6

how do you test for vas previa

Answer 6

Apt test= fetal Hb resists lysis by alkaline sol’n

Question 7

severe preeclampsia: definitive therapy.

Answer 7

delivery

Question 8

What happens when Rh ab’s react? What to do to prevent it? how to diagnose/monitor it?

Answer 8

hemolytic disease of the newborn. Rh immun globulin to all Rh- women. Doppler systolic velocities, amnio