Prematurity (1) Flashcards
What is this defined as?
How is it classified?
What are its risk factors?
➊ Birth < 37 wks
➋ • <28 wks – extreme prematurity
• 28-32 wks – very premature
• 32-37 wks – moderate to late prematurity
➌ • Smoking
• Alcohol
• Drugs
• Overweight/Underweight mother
• Multiple pregnancies
• Hx of prematurity
Management:
Why is so important to delay labour in these situations?
What can be done prophylactically done to delay labour?
What should be done if premature labour is suspected/confirmed?
➊ Each extra week of gestation has a HUGE improvement on prognosis, so everything is done to delay labour
➋ • Prophylactic vaginal progesterone – Suppository put in vagina to discourage labour
• Prophylactic cervical cerclage – Suture cervix to hold it closed
➌ • Tocolysis with Nifedipine – Suppresses labour
• Maternal corticosteroids – Improve surfactant production and lung development to reduce risk/severity of respiratory dist.
• IV Magnesium Sulphate – Protects baby’s brain
• Delayed cord clamping or cord milking
What are the short-term complications here?
What are the long-term complications here?
➊ • Respiratory distress syndrome
• Hypothermia
• Hypoglycaemia
• Poor feeding
• Bradycardia
• Neonatal jaundice
• Necrotising enterocolitis
➋ • Chronic lung disease of prematurity
• Cerebral palsy
• LD
• Susceptibility to infections
• Hearing and visual impairment
