Premature labour

Question 1

Definition of premature labour

Answer 1

Delivery which occurs between 24- and 37-weeks gestation

Question 2

What are the risk factors for premature labour? Give me 8

Answer 2

‘Too much inside’ - Multiple pregnancy, polyhydramnios
‘Defenders escape’ - Pre-eclampsia, IUGR
‘Weak wall’ - fibroids
‘Enemy’ - UTI, STI
‘Problem with mum’ - extremes of age, maternal health problems i.e diabetes, renal disease

Question 3

Signs of premature labour

Answer 3

Sustained crampy abdo pain (could be Braxton-Hicks)

Cervical show

Question 4

Investigations for preterm labour and what does it mean?

Answer 4

1. Fetal fibronectin testing (determines chance of you going into labour before 34 weeks, meant for women after 30 weeks –> predicts chance of labour in 48 hours
2. Speculum to rule out PPROM
3. Fetal monitoring

Question 5

Scan to predict premature labour?

Answer 5

Cervical length of transvaginal sonography

Question 6

Surgical prevention for premature labour?

Answer 6

Cervical cerclage

Question 7

Medical Tx for premature labour?

Answer 7

Give if fetal fibronectin more than 50ng/ml:
Nifedipine (1st line) [Ca channel blocker]
Atosiban (2nd line) [oxytocin receptor antagonist

Question 8

Other drugs to give in premature labour for wellbeing of baby?

Answer 8

MgSO4 (neuroprotection)

Betamethasone –> helps fetal surfactant pdition