Preterm Delivery

Question 1

What are the classifications of prematurity?

Answer 1

Premature= before 37 weeks
Extreme < 28 weeks
Severe= 28-31+6
Moderate= 32-33+6
Late= 34-36+6

Question 2

What are the risk factors for prematurity?

Answer 2

Smoking, BMI <19.8 or >30, Infection, diabetes, polyhydramnious and multiples

Question 3

How do you manage a preterm labour?

Answer 3

Fetal fibronectin, corticosteroids, nifedipine, fetal monitoring and antibiotics

Question 4

What are the complications of preterm labour?

Answer 4

Infection, psychological trauma, death, RDS (fetal), poor glucose control, poor temp control

Question 5

How to prevent preterm labour?

Answer 5

Healthy lifestyle, antenatal care, risk assessment, infection screening

Question 6

Define Premature rupture of membranes

Answer 6

Spontaneous rupture of membranes before 37 week and before onset of labour

Question 7

How do you diagnose PROM?

Answer 7

Nilazine test, USS, pool of fluid seen

Question 8

How do you manage a PROM?

Answer 8

Corticosteroids, antibiotics and amnioinfusion

Question 9

What is the dosage of corticosteroids?

Answer 9

Betamethasone= 12 mg IM 2 doses 24 hours apart
Dexamethasone= 6 mp IM 4 doses 12 hourly

Question 10

What are the advantages and disadvantages of corticosteroids?

Answer 10

Advantages= Reduces RDS, reduces intraventricular hemorrhage, decreases prenatal death 
Disadvantages= increases congenital abnormality, increases IUGR (with prolonged exposure)

Question 11

What is the dosage of nifedipine?

Answer 11

20mg followed by 10-20mg 3-4 times a day

Question 12

What are the advantages and disadvantages of nifedipine?

Answer 12

Advantages= increases gestational age, reduces NICU admission
Disadvantages= increases constipation, increases vasodilation