Lecture 16 - Preterm Birth

Question 1

Preterm labour definition?

Answer 1

labour before 37 weeks gestation, very preterm < 32 weeks

Question 2

Mechanisms of spontaneous preterm birth?

Answer 2

intrauterine stretch (related to CAP, cytokines and prostaglandins, as well as membrane disruption), endocrine maturation, intrauterine hemorrhage, intrauterine infection

Question 3

Preterm activation?

Answer 3

fetal genome, uterine strss, fetal HPA axis, abnormal membrane rupture, cervical changes (infection leading to early inflammation

Question 4

Placentation causes of preterm birth?

Answer 4

growth of fetus, poor attachment (bleeding), progesterone, prostaglandins

Question 5

Problems of preterm birth?

Answer 5

fetal health, fetal outcomes, maternal co-morbidity, breech risk, complicated c section, recurrence risk

Question 6

Iatrogenic premature birht?

Answer 6

maternal disease (preeclampsia), FGR; other types being sponataneous

Question 7

Taking history: risk of preterm birth?

Answer 7

previous PTB, smoking, cervical surgery, maternal disease, antepartum bleeding

Question 8

Cervix and PTB?

Answer 8

small cervix length leads to greater risk

Question 9

Fetal fibronectin?

Answer 9

biological glue beween amniotic and chorion membranes, high concentrations in 1st trimester nad late pregnancy only, normally low in between

Question 10

Tocolysis?

Answer 10

suppresses preterm labour, Ca channel and oxytocin receptor blockers

Question 11

Antenatal corticosteroids (betamethasone)?

Answer 11

prevention of neonatal death from respiratory distress syndrome

Question 12

Magnesium sulphate?

Answer 12

neuroprotection