Obstetrics and Gynecology Flashcards
Definition of preterm labour
Labour that occurs before 37 weeks
What is labour that occurs before 24 weeks?
Threated miscarriage
When is preterm birth done purposely?
May be performed in preeclampsia, maternal disease necessitating delivery and IUGR
Spontaneous causes of preterm delivery?
Preterm labour
PPROM
Cervical incompetence
Risk factors for preterm birth NON PREGNANCY RELATED
- low SES
- extremes of age
- poor nutritional status
- smoking
- drug abuse
Risk factors for preterm birth PREGNANCY RELATED
- multiple pregnancy
- PPRPOM
- uterine anomolies
- history of preterm delivery
- placenta previa
- placental abruption
- polyhydramnios
- intrauterine infection
How is fetal fibronectin used to predict preterm birth?
-rarely present in secretions between 23-35 weeks - positive swab suggests risk of preterm birth (partosure)
How is transvaginal ultrasound used to predict preterm birth?
Use it to measure cervical length - the shorter the cervix the more likely preterm birth
Diagnosis of preterm labour?
Regular painful contractions <37 weeks AND cervical changes AND cervical dilation
Management of preterm labour?
- Steroids
- Tocolysis
- MgSO4 if <32 weeks
- Transfer to tertiary care
when should you administer MgSo4?
If birth is suspected in the next 12 hours and gestation is less than 32
neonatal consequences of preterm birth?
- RDS
- NEC
- intraventricular hemorhage
- periventricular leukomalacia
- sepsis
- patent ductus arterosis
- intellectual impairment/CP
- death
What is preterm premature rupture of membranes?
ROM before 37 weeks and prior to the onset of labour
What is prolonged rupture of membranes?
ROM > 24 hours
Risk factors for PPROM?
- spontaneous/idiopathic
- infection - chlamydia, group B strep
- smoking
- placental abruption
- PPROM in prior pregnancy
- incompetent cervix
- multiple pregnancy
- polyhydramnios
- Iatrogenic
