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Obstetrics I - OSCE > Prematurity > Flashcards

Prematurity Flashcards

1
Q
A
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2
Q

Etiology & RF for Prematurity

A
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3
Q

Etiology & RF for Prematurity

  • Maternal Factors
A
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4
Q

Etiology & RF for Prematurity

  • fetal Factors
A

1) Fetal anomalies
2) multiple infections as TORCH
3) IUFD.

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5
Q

Etiology & RF for Prematurity

  • obstetric Compications
A

1) Polyhydramnios, PPROM
2) Chorioamnionitis
3) placenta previa, placental abruption
4) pregnancy on top of IUD.

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6
Q

Etiology & RF for Prematurity

  • Iatrogenic Factors
A

1) Premature induction of labor
2) ECV
3) amniocentesis or surgery.

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7
Q

Etiology & RF for Prematurity

  • Idiopathic
A

In 50% of cases

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8
Q

Etiology & RF for Prematurity

  • Commonest Cause
A

Idiopathic

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9
Q

Complications of Prematurity

A
  • Long term
  • Short term
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10
Q

Complications of Prematurity

  • Long-term
A
  • ↑↑ incidence of underdevelopment.
  • ↑↑ incidence neurological & intellectual abnormalities later in life.
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11
Q

Complications of Prematurity

  • short Term
A
  • Respiratory
  • Brain
  • Blood
  • Metabolic
  • Others
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12
Q

Short term Complications of Prematurity

  • Respiratory
A
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13
Q

Dx of Preterm Labor

A
  • Prediction
  • Manifestations of threatened preterm labor
  • Criteria to document preterm labor
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14
Q

Dx of Preterm Labor

  • Prediction
A
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15
Q

Dx of Preterm Labor

  • Manifestations
A
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16
Q

Dx of Preterm Labor

  • Criteria
A
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17
Q

Dx of Prematurity

A
  • Before delivery
  • After delivery (Features of prematurity at birth)
18
Q

Dx of Prematurity

  • Before Delivery
A

Tests for determination of fetal maturity

19
Q

Dx of Prematurity

  • After Delivery
20
Q

Prevention of Preterm Labor

A
  • General
  • Rest
  • Cervical Cerclage
  • Prophylactic tocolytic
21
Q

Prevention of Preterm Labor

  • general Measures
22
Q

Prevention of Preterm Labor

  • rest
A

In high risk cases as in:
- cervical incompetence, multifetal pregnancy.
- previous preterm labor, PPROM or after uterine manipulation

23
Q

Prevention of Preterm Labor

  • cervical Cerclage
A

Done when indicated as in:
- cervical incompetence, uterine anomalies
- multifetal pregnancy or previous preterm labor

24
Q

Prevention of Preterm Labor

  • tocolytics
A

Not recommended

25
Q

Managment of Preterm Labor

A
  • Bed Rest
  • Sedatives & narcotics
  • Tocolytics
  • Corticosteroides
  • managment of Delivery
  • Neonatal Care
26
Q

Managment of Preterm Labor

  • Sedatives & Narcotics
A

As barbiturates, diazepam & pethidine:
▪ these agents depress preterm infant when administrated to mother near time of delivery

27
Q

Managment of Preterm Labor

  • Bed Rest
A

Preferably in Lt lateral position to improve uterine blood flow.

28
Q

Managment of Preterm Labor

  • Tocolytics
29
Q

Types of Tocolytics

A
  • Short term
  • Long term
30
Q

Def of Tocolytics

A

Tocolytics are drugs that inhibit uterine contractions.

31
Q

Types of Tocolytics

  • Short term
A

Indicated to:

  • Delay labor 2-3 days till achieving max. effect of steroids.
  • Prevent preterm labor after abdominal or cervical
    operations or uterine manipulation.
32
Q

Tocolytics

  • If pregnancy is ( ) 34 & 37 weeks
A
  • Decision of tocolysis depends on quality of care available for premature infants & estimated fetal weight
33
Q

Types of Tocolytics

  • Long term
A

Not effective(oral):

  • As they stop uterine contractions temporarily but rarely prevent preterm birth
34
Q

CI of Tocolytics

35
Q

Tocolytics

  • Drugs Used
A
  • β-agonists
  • Magnesium sulfate (MgSO4)
  • PG synthetase inhibitors (anti-PGs)
  • Ca++ channel blockers (Nifedepine).
  • Oxytocin antagonists (atosiban)
  • Progesterone(17 α-Hydroxyprogesterone caproate)
  • Others
36
Q

Management of delivery (conduct of preterm labor)

  • Place
A
  • In well equipped hospital with availability of neonatal intensive care & neonatologist efficient in resuscitative techniques present at delivery room
37
Q

Management of delivery (conduct of preterm labor)

  • Methods
38
Q

Management of delivery (conduct of preterm labor)

  • Vaginal
39
Q

Vaginal Delivery of Preterm Labor

  • During 1st stage
40
Q

Vaginal Delivery of Preterm Labor

  • During 2nd Stage
A

Important precautions:
- Generous episiotomy once head reaches perineum.
- Outlet forceps is the only type of forceps allowable.
- Ventouse is contraindicated.
- No vigorous manipulations

41
Q

Vaginal Delivery of Preterm Labor

  • during 3rd stage
A

As normal labor.

42
Q

CS Delivery of Preterm Labor

Obstetrics I - OSCE (32 decks)

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