8 - Obs - Preterm Delivery - Ix + MGMT

Question 1

Ix
-To assess fetal state: ??? and ???

-To assess likelihood of delivery: if cervix ?, fetal ?
assay helpful, ?ve result means preterm deliv unlikely. TVUSS of cervical ? also predictive – unlikely if >?mm.

-To look for Infection: Vaginal ?
taken, ? speculum if membranes ?. Maternal CRP rises w ?, WCC estimation useful but ? incr it.

Answer 1

CTG + USS

uneffaced
fibronectin
-ve
length
>15

swabs
sterile
ruptured
chorioamnionitis
steroids

Question 2

MGMT - Steroids

• given ?-?wks. In women only presx w ?, can be restricted to those fibronectin ?ve or ?
  cervix. Reduce ? morb and mort by promoting ? maturity. Don’t incr risk of ? but careful ? control in ?. Take ? to act, so deliv delayed artificially w ?. ? doses not advised.

Answer 2

24-34
contractions
\+
short
perinatal
pulmonary
infection
glucose
diabetics
24h
tocolysis
repeat

Question 3

MGMT - Tocolysis
? or ?, oxytocin-r ?, given to allow ? time to act or allow in ? transfer to ???? unit. Delay preterm labour, not used for >?. Ritodrine or ? and NSAIDs also delay but have ?s

Answer 3

nifedipine
atosiban
antagonists
steroids
utero
NICU
24h
salbutamol
SEs

Question 4

MGMT - Detection and Prevention of Infection:

Presence of infection within ?
risks ? health and considerably worsens ?
outlook. May even occur w/o ? rupture, chorioamnionitis warrants IV ? and ? delivery. Abs not given to simply threatened preterm labour (? ? risk).

Answer 4

uterus
maternal
neonatal
membrane
ABx
immediate
cognitive impairment

Question 5

MGMT - Delivery

Mode of Delivery: ? reduces incidence of ? distress syndrome in ?, C section done only for usual ?
indications. ? presx more common in preterm, ? c section usual.

Abx for Delivery: For women in ? preterm labour (not ?) due to incr risk and morb of ???.

Answer 5

vaginal
resp
neonate
obstetric
breech
elective

actual
threatened
GBS

Question 6

MGMT - Delivery

Conduct of Delivery: ?
facilities mobilized. Membranes not ? in labour up to ? wks – labour may be ?, allowing ? more time to act and membranes may ?
delicate preterm fetus against ?. ? > ventouse used for obstetric indications. Unless immed ? resus req, cord not ? for ? secs to reduce neonatal morb.

Answer 6

paed
ruptured
32
slow
steroids
cushion
trauma
Forceps
neonatal
clamped
45