Premature labour

Question 1

What does Rupture of Membranes (ROM) mean?

Answer 1

Rupture of membranes means the amniotic sac has ruptured.

Question 2

What is Spontaneous Rupture of Membranes (SROM)?

Answer 2

Spontaneous rupture of membranes means the amniotic sac has ruptured spontaneously.

Question 3

What is Prelabour Rupture of Membranes (PROM)?

Answer 3

Prelabour rupture of membranes means the amniotic sac has ruptured before the onset of labour.

Question 4

What is Preterm Prelabour Rupture of Membranes (P-PROM)?

Answer 4

Preterm prelabour rupture of membranes is when the amniotic sac ruptures before the onset of labour and before 37 weeks gestation.

Question 5

What is Prolonged Rupture of Membranes?

Answer 5

Prolonged rupture of membranes occurs when the amniotic sac ruptures more than 18 hours before delivery.

Question 6

How is prematurity defined?

Answer 6

Prematurity is defined as birth before 37 weeks gestation.

Question 7

What is the chance of survival for a baby born at 23 weeks?

Answer 7

A baby born at 23 weeks has around a 10% chance of survival.

Question 8

What does the World Health Organisation classify as “extreme preterm”?

Answer 8

Extreme preterm is defined as birth before 28 weeks gestation.

Question 9

What is the role of vaginal progesterone in the prophylaxis of preterm labour?

Answer 9

Vaginal progesterone can be given to prevent preterm labour by decreasing myometrial activity and preventing cervix remodelling in women with a cervical length less than 25mm between 16 and 24 weeks gestation.

Question 10

What is Cervical Cerclage?

Answer 10

Cervical cerclage is a procedure where a stitch is placed in the cervix to prevent premature delivery. It is offered to women with a short cervix, a history of preterm birth, or cervical trauma.

Question 11

How can Rupture of Membranes be diagnosed?

Answer 11

Rupture of membranes can be diagnosed by speculum examination revealing pooling of amniotic fluid. Tests like IGFBP-1 or PAMG-1 can be used to confirm the diagnosis.

Question 12

What is the management for Preterm Prelabour Rupture of Membranes?

Answer 12

Prophylactic antibiotics like erythromycin are given, and induction of labour may be considered from 34 weeks.

Question 13

What does “Preterm Labour with Intact Membranes” mean?

Answer 13

Preterm labour with intact membranes involves regular painful contractions and cervical dilation without rupture of the amniotic sac.

Question 14

How can preterm labour be diagnosed?

Answer 14

Diagnosis is made by clinical assessment, including a speculum examination and, if necessary, a transvaginal ultrasound or fetal fibronectin test.

Question 15

What is Tocolysis?

Answer 15

Tocolysis involves the use of medications like nifedipine to stop uterine contractions and delay delivery in preterm labour.

Question 16

What role do antenatal steroids play in preterm labour?

Answer 16

Antenatal steroids, like betamethasone, are given to help develop fetal lungs and reduce respiratory distress syndrome after delivery in preterm labour.

Question 17

What is the purpose of Magnesium Sulfate in preterm labour?

Answer 17

Magnesium sulfate is given to protect the fetal brain during premature delivery, reducing the risk of cerebral palsy.

Question 18

What are the signs of magnesium sulfate toxicity?

Answer 18

Signs of magnesium sulfate toxicity include reduced respiratory rate, reduced blood pressure, and absent reflexes.