Prem/PROM/Multiple pregnancy

Question 1

List possible causes of PREMATURITY

Answer 1

• Multiple pregnancy
• Chorioamnionitis
• Pre-eclampsia
• Placental abnormalities
• PPROM
• Cervical incompetence eg. prev cerclage or LLETZ
• Uterine abnormalities
• Prev CS at fully
• Alcohol/substance abuse + low socioeconomic status
• Trauma

Question 2

explain the term IUGR

Answer 2

Intrauterine Growth Restriction
Cetus hasn’t reached its growth potential because of genetic or environmental factors.

Question 3

causes of IUGR

Answer 3

• Chronic hypoxia
• PET
• Severe anaemia
• Sickle cell disease
• Multiple pregnancy
• Virus
• Substance abuse

Question 4

complications associated with a pre-term baby

Answer 4

• Respiratory distress syndrome
• Chronic lung disease
• Apnoeas
• Anaemia
• Patent ductus arteriosis
• Hypothermia
• Necrotising enterocolitis
• Intraventricular haemorrhage
• Retinopathy of prematurity

Question 5

When should a VE NOT be done on preterm?

Answer 5

should NOT VE on preterm with ruptured membranes

Question 6

What gestation is suitable for fatal fibronectin diagnostic?

Answer 6

23- 34+6 weeks

Question 7

What can be done for threatened PTL with intact membranes?

Answer 7

• Rescue cervical cerclage
• Arabin pessary

Question 8

When can corticosteroids be given?
What is the corticosteroid and dosage?

Answer 8

between 23- 34+6 weeks
2x Betamethasone 12mg given 12-24hrs apart

Question 9

When can MgSO4 be given (NICE + OUH)?
What is the dosage?

Answer 9

NICE: 24-30 weeks
OUH: 22+6- 31+6 weeks

4g slow IV bolus, can rpt after 12hrs
If birth imminent, administer this before the steroids