Exam 3 - Second Trimester: Preterm Labor

Question 1

What is the definition of preterm labor?

Answer 1

Labor that happens too early, before 37 weeks of pregnancy

Question 2

Risk factors for preterm labor

Answer 2

• Previous preterm birth
• Short cervical length (<25 mm at 24-28 weeks)
• Prior cervical or uterine surgery
• Asymptomatic bacteria seen with UTI, genital tract infections, periodontal disease, vaginal bleeding

Question 3

Current pregnancy risk factors that put the patient at risk for preterm labor

Answer 3

• Cervical insufficiency
• Maternal age <15 or >40
• Multiple gestation
• Hydramnios
• Low maternal weight BMI <19.8
• Severe maternal illness such as HELLP syndrome
• Preeclampsia
• Placenta previa
• Intrauterine infection
• Smoking
• Fetal growth restriction

Question 4

What lifelong disabilities are associated with preterm labor?

Answer 4

• CNS complications, CP, developmental delay
• Vision defects, hearing loss
• Altered pulmonary function
• Metabolic and cardiovascular risk
• Decreased long term survival

Question 5

Signs and symptoms of preterm labor

Answer 5

• Pelvic pressure
• Low back pain
• Abdominal tightness or cramps
• Contractions occurring more than six in one hour
• Fetus dropping low into pelvis before 36 weeks gestation
• Increased vaginal discharge
• Vaginal bleeding
• Diarrhea

Question 6

Diagnostic criteria for preterm labor

Answer 6

• Uterine contractions occurring between 20-36 weeks
• Cervical effacement >80%
• Cervical dilation >1 cm

Question 7

Management of suspected preterm labor

Answer 7

Women with backache, contractions, pelvic pressure, vaginal discharge should be evaluated immediately for preterm labor

• Referred to OB triage/OB emergency room for assessment and treatment