Preterm Labour Flashcards
What is preterm labour?
The onset of labour before 37 completed weeks of gestation
What is mild premature labour?
Labour between 26 and 32 weeks’ gestation
What is extreme premature labour?
Labour between 24 and 28 weeks’ gestation
At what gestation is a baby considered non-viable?
Before 23 weeks gestation
At what gestation would we conduct full resuscitation?
From 24 weeks onwards
What are the six risk factors of preterm labour?
Previous Preterm Labour
Multiple Pregnancy
Polyhydramnios
Antepartum Haemorrhage
Urinary Tract Infections
Stressful Life Event
What investigation is used to predict preterm labour?
Fetal fibronectin test
What is fetal fibronectin? What is its function?
A protein produced at the boundary between the amniotic sac and the lining of the mother’s uterus
To maintain the integrity of this binding
Describe the vaginal fluid levels of fetal fibronectin in pregnancy
It is high during early pregnancy
This is due to normal growth and establishment of the tissues at the junction between the amniotic sac and uterus
After this phase is complete, the levels fall
When fetal fibronectin test result predicts preterm labour?
The presence of elevated fetal fibronectin between weeks 22 and 35 of pregnancy
What three drugs are prescribed to manage preterm labour?
Tocolytic Drugs
Corticosteroids
Magnesium Sulphate
What is the function of tocolytic drugs in labour?
To slow down uterine contractions
They may be used for 48 hours to delay preterm labour – allowing further fetal development, corticosteroids to provide maximum benefit or for the patient to be transported to a more specialised care unit
What is the first line tocolytic drug for preterm labour?
Nifedipine
What is the drug class of nifedipine?
Calcium channel blocker
What is the second line tocolytic drug?
Atosiban
What is the drug class of atosiban?
Oxytocin receptor analogue
What is the function of corticosteroids in preterm labour?
To promote the baby’s lung maturity, thus reducing the risk of respiratory distress syndrome after delivery
When do we prescribe corticosteroids to preterm labour patients?
They are used in women with suspected preterm labour less than 36 weeks gestation
What is the function of magnesium sulphate in preterm labour?
To protect the fetal brain, thus reducing the risk of and severity of cerebral palsy
When and how do we administer magnesium sulphate in preterm labour patients?
It is given intravenously to the mother within 24 hours of delivery
It is given as a bolus, followed by an infusion for up to 24 hours or until birth
At what gestation is magnesium sulphate prescribed to preterm labour patients?
Before 34 weeks gestation
