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OBGYN > OBAb: Preterm Labor > Flashcards

OBAb: Preterm Labor Flashcards

1
Q

____ is preterm RUC but cervix is closed

A

threatened preterm labor

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2
Q

___ threshold of viability (both weeks and grams)

A

26 weeks, 750 grams

Note: DNR is <23 weeks, and <400g

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3
Q

____grams to be considered as VLBW

A

<1500grams

ELBW <1000g
LBW <2500g

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4
Q

____ risk increase of another preterm if prior preterm delivery if the first baby is less than 34 weeks

A

16x increased risk

If <35 weeks, 5x increased risk

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5
Q

___ risk increase of another preterm if the 1st and 2nd baby are <34 weeks

A

41x increased risk

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6
Q

Infection causes preterm delivery. Chorioamnionitis is usually cause by these 2 bacteria namely, ____ and ____

A
  1. Ureaplasma urealyticum

2. Mycoplasma hominis

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7
Q

ESR and CRP cut-off for infection

A

ESR >60

CRP >12

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8
Q

____ weeks AOG is the ideal time to do cerclage

A

14 to 22 weeks AOG

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9
Q

___ ng/mL of fetal fibronectin at 24-34 weeks may suggest preterm labor

A

more than 50ng/mL

(+) FFN increases the risk of preterm delivery in 7-10 days

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10
Q

What is the abnormal value for the cervical length at 24weeks AOG?

A

<=2.5cm

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11
Q

How will you give corticosteroids in patients suspected of preterm labor at 24-34 weeks AOG. For both Betamethasone and Dexamethasone.

A

Dexamethasone 6mg IM q12hrs x 4 doses
Betamethasone 12mg IM every 24 hours x 2 doses

Corticosteroids is given to prevent IVH

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12
Q

How will you administer nifedipine as tocolytic?

A

Loading dose: 30mg

Maintenance dose: 10-20mg q4-6hrs

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13
Q

What are the contraindications in giving tocolytics?

A
  1. Abruptio
  2. Severe pre-eclampsia
  3. Intrauterine infection
  4. lethal congenital anomaly
  5. Advanced cervical dilatation (>4cm)
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14
Q

This tocolytic should not be given for more than 48 to 72 hours since it may cause pulmonary edema.

A

Terbutaline

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15
Q

Aside from terbutaline, this beta mimetic drug is given for tocolysis.

A

Isoxuprine

Dont give this in placenta previa

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16
Q

in patients with a previous history of preterm labor with a short cervix, one can give this drug intravaginally (name the drug and dose)

A

Micronized progesterine (Utrogestan) 200mcg to max 800mcg OD

17
Q

What are the clinical criteria for preterm labor?

A
  1. Contractions >/6 per hour

2. Cervix >/3cm, 80% effaced

18
Q

When will you screen for cervical length?

A

16-24weeks

19
Q

What is the normal length of the cervix?

A

> 2.5cm

20
Q

What is the most common cause of preterm birth?

A

Placenta previa or placenta abruptio

21
Q

How will you give the loading dose of magnesium sulfate

A

4-6g SIV over 20 mins

22
Q

How will you give the maintenance dose of magnesium sulfate?

A

2g/hour for 24 to 48 hours

23
Q

What is the tocolytic agent of choice?

A

Niedipine

LD 30 to 40mg/tab
MD: 30mg/day to 160mg/day in divided doses

24
Q

To control preterm labor, progesterone is given ___

A
  1. Weekly 250mg IM from 16 to 20 weeks through 36 weeks

2. Daily 200mg/vaginal from 24 to 34 weeks AOG

25
Q

[Pharma]

___ is an oxytocin receptor antagonis

A

Atosiban

26
Q

What are the dreaded adverse effects of Indomethacin in patients with premature labor?

A
  1. Premature closure of ductus arteriosis
  2. Persistent PDA
  3. IVH
27
Q

What is the standard antibiotic therapy for treating premature labor?

A
  1. Ampicillin2g IV q 6 hours PLUS

2. Gentamicin 1.5mg/kg every 8 hours

28
Q

Prophylactic cerclage is done at ___ weeks AOG

A

10-12 weeks AOG

29
Q

Corticosteroids are given between ___ for lung maturity

A

24 and 34 weeks AOG

30
Q

What steroids will you give to facilitate lung maturity?

A
  1. Betametahsone 12mg/IM every 24 hours for 2 doses

2. Dexamethasone 6mg IM every 12 hours for 4 doses

31
Q

What is the only reliable indicator of clinical chorioamninitis?

A

Fever

32
Q

What are the criteria for chorioamnionitis

A

Maternal fever >/ 38 deg C PLUS 1:

  1. Fetal tachycardia
  2. Uterine tenderness
  3. Purulent or foul-smelling discharge
  4. Leukocytosis
  5. Increased ESR
33
Q

What is the treatment regiment for maternal chorioamnionitis?

A

First 48 hours:

  1. Ampicillin 2g/IV q6
  2. Erythromycin 250mg q6

After 48 hours

  1. Amoxicillin 250mg q8hrs
  2. Erythromycin 250mg q8
34
Q

[Fetal Growth Disorders]

Symmetrical growth retardation is due to an early insult resulting to ____

A
  1. Decrease cell number and size

2. Proportionate reduction of both head and body

OBGYN (33 decks)

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