Abdnormal Labor

Question 1

What is preterm labor ?

Answer 1

• regular contractions
• cervical changes
  —effacement , dilation —-
  BUT!, it happens between 20-24 weeks and 37 weeks

Question 2

When is it considered an abortion ?

Answer 2

Before 20-24 weeks

Question 3

What are the risk factors for preterm labor ?

Answer 3

1) smoking
2) alcohol
3) drugs
4) prior preterm
5) multiples ( twins )
6)short cervical length ( less than 25 mm)
7) cervical surgery
8) urinary , genital infection
9) preeclampsia or eclampsia
10 ) hellp syndrome
11) placenta previa or abruption

Question 4

Prophylaxis ?

Answer 4

Intra vaginal progesterone

Question 5

Managing preterm labor for cervix that is longer than 30 mm

Answer 5

• observation for 4-6 hours
• discharge and reevaluate 2 weeks later

Question 6

Managing preterm labor for cervix that is shorter than 20mm

Answer 6

1) Antenatal corticosteroids for fetal lung maturity
2) Tocolytic medications like nifedipine,NSAIDS, terbutaline that suppress contractions
3) Antibiotics like ampicillin and gentamicin to prevent infection
4) magnesium sulfate which decreases cerebral palsy

Question 7

What is post term labor ?

Answer 7

Happens after 42 weeks
Risk is previous posterm labor
Management by
- fetal monitoring
- induction of labor

Question 8

When should we do induction of labor ?

Answer 8

When there is Oligohydramnios or fetal distress

Question 9

How do we induce labor ?

Answer 9

Amniotomy
Cervical ripening agent ( prostaglandin, ballon catheter)
Oxytocin

Question 10

Management of prolonged latent phase

Answer 10

• oxytocin
• amniotomy if membrane is not ruptured

Question 11

Management of prolonged active phase

Answer 11

Oxytocin
Amniotomy
C section

Question 12

Management of prolonged second stage

Answer 12

Oxy
C section
Operative vaginal delivery

Question 13

Management of prolonged third stage of labor

Answer 13

If retained placenta then
- oxy
- controlled cord traction
- manual extraction