Preterm Labor

Question 1

Definition of pre-term labor

Answer 1

Onset of labor before 37 weeks gestation

Question 2

Chorioamnionitis also causes Periventricular leukomalacia (PVL) what is that?

Answer 2

White matter damage to the developing brain of the infant

Question 3

Testing cervicovaginal fluid levels of fetal fibronectin has value why?

Answer 3

As it has predictive value of pre term labor

Question 4

Tocolytics are admin’d for what use?

Answer 4

Delay delivery long enough for corticosteroid admin. Corticosteroid admin improves long function

Question 5

Magnesium sulphate reduces the risk of what in surviving infants?

Answer 5

Cerebral Palsy

Question 6

Beta-sympathomimetics are a class of tocolytics, however they have significant maternal side effects, what’s the most serous?

Answer 6

Pulmonary oedema

Question 7

What is the Tocolytic with the least side effects and best toleration

Answer 7

Atosiban an OTR-A (Oxytocin receptor antagonist)

Question 8

The Tocolytic NSAID, Indomethacin has several fetal side effects like…?

Answer 8

premature closing of ductus arteriosus, could lead to pulmonary hypertension

Question 9

What’s the current 2 Corticosteroids of choice

Answer 9

Beta and dexamethasone

Question 10

What is the surgical preventative treatment of pre term birth

Answer 10

Cervical cerclage

Question 11

Indications of cerclage

Answer 11

.1 history of PTD
.2 Cervix <25mm (US indicated cerclage)
.3 crevix is dilating in the absence of contractions

Question 12

Vaginal progesterone does what

Answer 12

Reduces risk of PTB in patients with prior spontaneous PTB

Question 13

Which uterine anomaly most increases risk of PTB?

Answer 13

Bicornuate uterus

Question 14

A 22-week ultrasound shows Uterine Didelphys, what is the patient at highest risk for?

Answer 14

2nd trimester loss. Mullerian anamolies lead to Miscarriage/PTD

Question 15

A patient presents with painless dilation, what does she need?

Answer 15

Cerclage.