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Obstetrics > Preterm Labor > Flashcards

Preterm Labor Flashcards

1
Q

What is the greatest risk factor for preterm labor?

A

previous preterm birth

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2
Q

How is preterm labor defined?

A

birth prior to 37 weeks

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3
Q

What lab test do we use to measure preterm labor?

A

fetal fibronectin

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4
Q

Fetal fibronectin has a very high _____ predictive value.

A

negative

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5
Q

Cervical length assessment is recommended for preterm labor until how many weeks?

A

24 weeks

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6
Q

What is the first thing you should do for maternal hemorrhage with hemodynamic instability? (this question will be on exam)

A

make sure mother is ok

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7
Q

What are the 4 basic things that are always done in the management of preterm labor?

A
  1. steroids
  2. tocolytic drugs
  3. neuroprotection
  4. antibiotics (GBS prophylaxis)
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8
Q

What do tocolytic drugs do?

A

stop uterine contractions

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9
Q

What are the 3 most common tocolytic agents used to treat preterm labor?

A
  • magnesium sulfate
  • indomethacin
  • nifedipine
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10
Q

What are the only 2 indications in which terbutaline is still used?

A
  • external cephalic version

- hyperstimulation

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11
Q

What are the 3 contraindications for terbutaline?

A
  • maternal cardiac disease
  • hemorrhage
  • diabetes
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12
Q

This drug is commonly used in patients at risk for preterm delivery to reduce the risk for cerebral palsy.

A

magnesium sulfate

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13
Q

What is the antidote for magnesium toxicity?

A

calcium gluconate IV

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14
Q

what are the 3 contraindications for magnesium?

A
  • myasthenia gravis
  • maternal cardiac conduction defects
  • maternal renal impaiment
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15
Q

What is the risk of concomitant use of CCB with magnesium?

A
  • respiratory depression
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16
Q

You should have caution when administering Nifedipine in women with this condition.

A

left ventricular dysfunction and CHF

17
Q

Indomethacin can be used until how many weeks?

A

28-29 weeks

18
Q

Indomethacin administration is contraindicated in these 5 conditions.

A
  • platelet dysfunction or bleeding disorders
  • hepatic dysfunction
  • GI ulcerative disease
  • asthma
  • renal dysfunction
19
Q

This medication is an appropriate first-line tocolytic for early preterm labor (<30 wk) or preterm labor associated with polyhydramnios.

A

indomethacin

20
Q

What is the main goal with tocolytics?

A
  • delay pregnancy by 48 hours to complete a steroid course
21
Q

Administering this drug is known to decrease risks of most neonatal complications (IVH, NEC, respiratory distress).

A
  • Steroids (Bethamethasone [Celestone])
22
Q

What is the difference in PROM and PPROM in terms of when the rupture of the membrane happened?

A
  • PROM = rupture before onset of labor

- PPROM = rupture before 37 weeks of gestation

23
Q

What is the first physical exam you should do in a patient with suspected ruptured membranes?

A

speculum exam

24
Q

This diagnostic test is only used if PPROM cannot be clinically diagnosed.

A

Dye test

25
Q

What is the treatment for PROM?

A
  • induction of labor
26
Q

What is the primary maternal risk with expectant management of PPROM?

A

infection

27
Q

At how many weeks can you deliver a PPROM pregnancy?

A

34+ weeks

28
Q

What are the 3 possible options for preventing recurrent preterm delivery?

A
  • progesterone supplements
  • cervical cerclage
  • cervical pessary
29
Q

What are the 3 common diagnostic tests used for PROM/PPROM?

A
  • Nitrazine test = paper turns blue in presence of amniotic fluid
  • Fern test = amniotic fluid has narrow fern
  • amniotic fluid index with u/s
30
Q

If the Amnisure or the ROM+ test is positive what does this mean?

A

patient has ruptured membranes

Obstetrics (12 decks)

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