Premature delivery

Question 1

Premature labour

Answer 1

Painful regular contractions + assoc cervical change

Preterm

Question 2

Risk factors for preterm labour

Answer 2

Previous preterm labour
Extremes of mat age, substance abuse, smoking, infection
Low socioeconomic status, lack of prenatal care, intense physical exertion /stress, uterine distension, pre eclampsia, APH, abruption, uterine abnormalities
PROM, multip, IUGR, congenital abnormalities

Question 3

Corticosteroids

Answer 3

Reduce incidence of neonatal Resp distress synd, intra ventricular haemorrhage, nec enterocolitis, neonatal death
Contraindicated in active maternal septicaemia
Caution in insulin dep diabetes!! -> DKA

Question 4

Tocolytics

Answer 4

Inhibit smooth muscle in uterus aiming to delay labour to allow steroids to take effect and transfer to appropriate hospital

Question 5

Mode of delivery

Answer 5

Vaginal if appropriate
C section / instrumental where indicated as in term delivery
Ventouse not

Question 6

PPROM

Answer 6

Rupture of membranes prior to onset of labour
10 day prophylactic abx
Steroids before 34th wk
Deliver 34-36 wks