prematurity Flashcards
When should resus of a premature baby be carefully considered?
<500 grams
24 weeks gestation
Outcomes are poor
Classifications of prematurity
- Under 28 weeks: extreme preterm
- 28 – 32 weeks: very preterm
- 32 – 37 weeks: moderate to late preterm
Associations with prematurity
- Social deprivation
- Smoking
- Alcohol
- Drugs
- Overweight or underweight mother
- Maternal co-morbidities
- Twins
- Personal or family history of prematurity
Which women do yuo consider delaying birth in
History of prem birth
Cervical lenth <25mm before 24 weeks
Options for delaying birth
Prophylactic vaginal progesterone - supposityr
Prophylactic cervical cerclage - suture in cervix to hold it closed
Options for improving premature labour
Tocolysis with nifedipines
Maternal corticosteorids
IV mg sulphate
Delayed cord clmaping or milking
Issues in early life with prematurity
- Respiratory distress syndrome
- Hypothermia
- Hypoglycaemia
- Poor feeding
- Apnoea and bradycardia
- Neonatal jaundice
- Intraventricular haemorrhage
- Retinopathy of prematurity
- Necrotising enterocolitis
- Immature immune system and infection
Long term effects of prematurity
- Chronic lung disease of prematurity (CLDP)
- Learning and behavioural difficulties
- Susceptibility to infections, particularly respiratory tract infections
- Hearing and visual impairment
- Cerebral palsy
What does nifedipine do to delya labour?
CCB 0 supressess ;abour
When are maternal corticosteroids offered
before 25 weeks - reduces neonatal morbiditiy and mortality
When is IV mg sulphte offered
before 34 weeks gestation - help protect babys brain
What does delayed cord clamping allow?
Increase circulating blood volume and Hb in baby
