Premature Labour Flashcards
define premature labour
<37/40
at how many weeks gestation are babies considered to be non-viable? (resuscitation will not be attempted)
below 23 weeks
2 measures that can be taken to prevent premature labour
PV progesterones
cervical cerclage
which results suggest that premature labour may be a problem?
cervical length (taken by TVUSS between 16 and 24 weeks)
<25mm indicates a risk of premature labour
when is cervical cerclage preferred to PV progesterones?
when the patient has had a previous premature birth or previous trauma to the cervix e.g. cone biopsy
when is “rescue” cervical cerclage performed?
when there is cervical dilatation before 28 weeks with no rupture of membranes - this helps to prevent premature labour
how is preterm rupture of membranes diagnosed?
how can fluid within the vagina be tested to make sure that it is definitely amniotic fluid?
when is this done?
prophylactic antibiotics in premature rupture of membranes
250mg erythromycin QDS for 10 days or until labour
prophylactic antibiotics in premature rupture of membranes
250mg erythromycin QDS for 10 days or until labour
at how many weeks would induction of labour be offered after PROM?
from 34 weeks gestation
PROM: what are the advantages/disadvantages of continuing the pregnancy?
continuation of the pregnancy = less risk of foetal respiratory distress, more risk of maternal chorioamnionitis
how is premature labour assessed before 30 weeks gestation?
clinical examination alone is enough to confirm labour
how is premature labour assessed after 30 weeks gestation?
clinical examination + TVUSS showing cervical length <15mm OR
clinical examination + vaginal foetal fibronectin <50ng/ml
simple measure that improves foetal outcomes in premature labour
delayed cord clamping/cord milking
2 methods of tocolysis in premature labour
nifedipine (first line)
atosiban
