preterm delivery

Question 1

when is a birth PRETERM

Answer 1

before 37 weeks

Question 2

when is a birth VERY PRETERM

Answer 2

before 32 wwks

Question 3

when is a birth EXTREMLEY

Answer 3

before 28 weeks

Question 4

risk factors groups for preterm birth

Answer 4

Previous preterm delivery

Second-trimester abortions

Uterine causes

Abnormal placentation

Infectious causes

Fetal causes

Question 5

what increases the likely hood of a previous preterm delivery

Answer 5

 Low socioeconomic status
 Maternal age
before 18
after 40

Question 6

examples of UTERINE causes for preterm birth

Answer 6

Myoma:
submucosal or subplacental

Uterine septum

Bicornuate uterus

Question 7

what is a Uterine septum

Answer 7

congenital malformation where the uterine cavity is partitioned by a longitudinal septum; the outside of the uterus has a normal typical shape.

Question 8

what is a Bicornuate uterus

Answer 8

is an abnormality of the uterus that has two horns and a heart shape.

Question 9

Abnormal placentation caussing preterm birth

Answer 9

Placenta previa:

Ablatio/Abruptio placentae

Question 10

what is placenta previa

Answer 10

abnormal position of the placenta causing it to cover the internal os of the cervix
1st degree: abnormal position but doesnt cover os
2nd: low position but does/t cover os
3rd: covers os but not during dilation
4th: completley covered os during dilation

Question 11

what is abruptio placentae

Answer 11

premature separation of the placenta from the uterus. causing internal or external bleeding

RF: db, HTN, cocaine, trauma, smoking, previous abruption, multiparity

causes painful bleeding

can lead to DIC from hemmorhage

Question 12

infections causing preterm delivery

Answer 12

Cervical/vaginal colonization
Acute pyelonephritis
Chorioamnionitis
Bacterial vaginosis

Question 13

what is chorioamnionitis

Answer 13

nfection that occurs before or during labor. The name refers to the membranes surrounding the fetus: the “chorion” (outer membrane) and the “amnion” (fluid-filled sac).

Question 14

fetal causes of preterm delivery

Answer 14

Intrauterine fetal death
Intrauterine growth retardation
Congenital anomalies

Question 15

what are the three stages of premature birth

Answer 15

Partus praematurus imminens
Partus praematurus incipiens
Partus praematurus progrediens

Question 16

what happens in IMMINENS

Answer 16

a. Unregular uterine contractions
b. Cervical canal is closed
c. Tocolitic therapy, Corticosteroids therapy, Antibiotic therapy

Question 17

what happens in INCIPIENS

Answer 17

a. Regular uterine contractions
b. Cervical change (cervical effacement of 80% or cervical dilatation)
c. Tocolitic therapy, Corticosteroids therapy, Antibiotic therapy

Question 18

what happens in PROGREDIENS

Answer 18

a. Regular uterine contractions
b. Cervical change (cervical effacement of 80% or cervical dilatation of 2cm or more)
c. PROM = premature rupture of membrane
d. Corticosteroids therapy, Antibiotic therapy

Question 19

management/dg of imminens and incipiens stages

Answer 19

Non stress test to evaluate uterine activity and fetal heart rate
Assess cervical status, progress of labour and presenting part.
Vaginal swab for bacteria vaginosis and B streptococcus and give antibiotic

Question 20

what is a non stress test

Answer 20

attaching one belt to the mother’s abdomen to measure

fetal heart rate, and another belt to measure contractions

Question 21

rx of preterm birth

Answer 21

tocolytic therapy

CorticoSteroid therapy

Question 22

which drugs are used in tocolytic therapy

Answer 22

magnesium sulfate: antagonises intracellular calcium, increases contraction

Terbutaline: beta 2 receptor, increase sympathetic action, decreaed intracellular calcium ions

Nifedipine: calcium channel blocker

Question 23

which drug is first choice for tocolytic therapy

Answer 23

magnesium sulfate

Question 24

which corticosteroids are used in preterm birth

Answer 24

Dexamethasone and betamethasone

Question 25

purpose of CS therapy

Answer 25

Stimulate pneumocyte 2 cell to produce surfactant

- 28 and 34 weeks of gestation.