PART 2222 Flashcards
time frame of childbirth considered premature
20
37 weeks
1 cause of neonatal morbidity and mortality
prematurity
cervical changes without uterine contractions are typically d/t
cervical insufficiency
cervical insufficiency definition
painless shortening or dilation of the cervix that occurs in the second or early 3rd trimester and results in preterm birth
cervical insufficiency is related to _____% of second trimester miscarriages
25%
cervical insufficiency is associated with what possible pathologies?
uterine anomalies DES exposure Cervical procedures (ie: conization)
what is cervical cerclage?
treatment for cervical insufficiency in which stitches are used to close the cervix during pregnancy in order to help prevent pregnancy loss or premature birth
When is cerclage done, removed, and who can’t get it?
done around weeks 14
16
removed around weeks 36
38
ineligible if the mother has cervicitis, dilation > 4 cm, or if the membranes have already ruptured
what are braxton hicks contractions?
contractions that occur without causing cervical changes painless contractions that are felt as tightening or pressure and last 10
20 minutes aka false labor usually get better with walking/activity
how many contractions are needed in order for cervical change to occur
> 4/hour
what are contractions felt as?
abdominal tightening, low back pain, or pelvic pressure
in order to be termed “preterm labor” what must be present?
contractions that are causing cervical effacement or dilation
what is the cause of preterm labor?
no idea
what are some risk factors for preterm labor?
Smoking
Cocaine
Uterine malformation
Cervical incompetence
Infection (STI, Group B Strep, UTI/Pyelo)
Low pre
pregnancy weight of mother
what are some complications of preterm labor for the mother and fetus?
Hypertension
Diabetes
Infection
PROM
Abruptio placentae
delivery of a baby
at a hospital with a NICU
cervical changes associated with preterm labor
Dilation of > 2 cm at presentation
Dilation of > 1 cm at serial exams
Effacement > 80% (2 cm)
what are some late symptoms of preterm labor?
Bloody mucus vaginal discharge (“bloody show”)
Contractions, pressure, cramps, and low back pain
what cervical length (found on US) increases the risk of preterm labor?
cervical length of 2 cm at 24 weeks
what is significant about Fetal Fibronectin found in cervical/vaginal secretions?
if present, the risk raises for delivery of the fetus within 2 weeks
If cervical length is less than 4 cm and FF is abnormal
50% chance of delivery before 34 weeks
If cervical length is 4 cm and Fetal Fibronectin is abnormal
11% chance of delivery before 34 weeks
3 reasons to obtain lung maturity via amniocentesis for diagnosis of preterm labor
If the estimated gestation date is uncertain, if you suspect chorioamnionitis, or if the fetus is > 34 weeks gestation
how is preterm labor managed?
Decisions are made based on estimated gestation date, estimated weight of the fetus, and existence of contraindications to suppressing preterm labor