Preterm labor

Question 1

Preterm labor

Answer 1

any birth < 37 weeks

spontaneous, pROM, or indicated

Question 2

3 causes of of labor

Answer 2

1) progesterone withdrawal
2) oxytocin initiation
3) decidual activation

Question 3

Cervical effacement precedes labor by

Answer 3

4-8 weeks

Question 4

Risk factors for preterm labor are

Answer 4

NOT CAUSATIVE

Question 5

Most imp risk factor of preterm labor is

Answer 5

a previous pre term labor

Question 6

How can infection cause preterm labor?

Answer 6

• microorganisms produce cytokines which stimulate prostaglandin production

Question 7

First trimester bleeding is associated with

Answer 7

incraesed risk for preterm labor or vaginal bleeding in general

Question 8

Diagnosis of preterm labor

Answer 8

• regular conrtactions leading to dilatation

- contractions alone dont diagnose

Question 9

what is fetal fibronectin

Answer 9

• trophoblastic protein

SHOULD NOT be present before 35 weeks

Question 10

Fetal fibronectin has

Answer 10

High sensitivity
Low specificity
HIgh NEGATIVE predictive value

Question 11

Contraindications to tocolysis

Answer 11

1- pre-eclampsia
2- choriomanionitis
3- previa/abruption
4- IUGR
5- mature fetus
6- fetal demise
7- mminient delivery

Question 12

Nifedipine

Answer 12

Ca Channel blocker
- reduces risk of preterm birth in 7 days
reduces risk of RDS, NEC, IVH

Question 13

Indomethacin

Answer 13

Prostaglandin synthetase inhibitor - reduce synthesis of Pg

reduce risk of pretern in 48 hours and 7 days,

Question 14

Risks with indomethacin use

Answer 14

• GA>32 wks, risk of premature closure of ductus arteriosus

- >48 hrs risk of oligohydramnios, renal insufficiency

Question 15

Tocolysis agents not in use

Answer 15

Mg Sulfate
Antocin other/oxytocin antagonists
Ritodrine -

Question 16

antenatal corticosteroids aer

Answer 16

NOT beneficial to mother

no role for multiple courses

Question 17

MgSo4 is used for

Answer 17

neuroprotection - reduce risk of CP

Question 18

Risks in previable PPROM

Answer 18

• lung hypoplasia

- limb contractures

Question 19

PPROM before 34 weeks

Answer 19

give Abx -
DONT give AMOX-CLAV risk of NEC in neonate
- NO TOCOLYSIS

Question 20

how does pPROM lead to neonatal death?

Answer 20

• prematurity
• sepsis
• pulmonary hypoplasia

Question 21

Difference between pre-eclampsia and gestational hypertension

Answer 21

Preeclampsia is accompanied by proteinuria, OR features of severe disease
bOTH AFTER 20 weeks

Question 22

Eclampsia

Answer 22

pre-eclampsia with encephalopathy

Question 23

Pre-eclampsia

Answer 23

new onset HTN with 
proteinuria OR
thrombocytopenia 
Abnormal liver enzymes 
renal impairment -