Management of Threatened Preterm Delivery ✅ Flashcards
What is the ultimate aim of the management of threatened preterm delivery?
To deliver the infant at full term whilst ensuring the well-being of both mother and infant
Who should the decision to deliver infants less than 28 weeks gestation involve?
- Obstetricians
- Neonatologist
- Parents
What needs to be assessed when deciding whether to deliver at less than 28 weeks?
Detailed assessment of risks to mother and infant
What management is known to improve neonatal outcome?
- Antenatal steroids
- Magnesium sulphate
What is the purpose of antenatal steroids in threatened preterm delivery?
Reduces rate of respiratory distress syndrome, intraventricular haemorrhage, and neonatal death
What is the purpose of magnesium sulphate in threatened preterm delivery?
Reduces risk of cerebral palsy in infants under <32 weeks gestation
What is there an increased risk of following PPROM?
Neonatal morbidity and infection
What proportion of cases of PPROM have positive amniotic cultures?
1/3
Why is there a high risk of infection in PPROM?
Due to ascending maternal infection from the lower genital tract
What is given in chorioamnionitis?
Antibiotics
Why are antibiotics given in chorioamnionitis?
To treat the condition in the mother, and reduce the risk of neonatal infection
What are tocolytics often used for?
Suppress contractions
What is the purpose of suppressing contractions with tocolytics in threatened preterm labour?
To allow time for antenatal corticosteroids or maternal transfer to perinatal centre
