Preterm Labour

Question 1

What is preterm labour?

Answer 1

The onset of labour before 37 completed weeks of gestation

Question 2

What is mild premature labour?

Answer 2

Labour between 26 and 32 weeks’ gestation

Question 3

What is extreme premature labour?

Answer 3

Labour between 24 and 28 weeks’ gestation

Question 4

At what gestation is a baby considered non-viable?

Answer 4

Before 23 weeks gestation

Question 5

At what gestation would we conduct full resuscitation?

Answer 5

From 24 weeks onwards

Question 6

What are the six risk factors of preterm labour?

Answer 6

Previous Preterm Labour

Multiple Pregnancy

Polyhydramnios

Antepartum Haemorrhage

Urinary Tract Infections

Stressful Life Event

Question 7

What investigation is used to predict preterm labour?

Answer 7

Fetal fibronectin test

Question 8

What is fetal fibronectin? What is its function?

Answer 8

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

Question 9

Describe the vaginal fluid levels of fetal fibronectin in pregnancy

Answer 9

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

Question 10

When fetal fibronectin test result predicts preterm labour?

Answer 10

The presence of elevated fetal fibronectin between weeks 22 and 35 of pregnancy

Question 11

What three drugs are prescribed to manage preterm labour?

Answer 11

Tocolytic Drugs

Corticosteroids

Magnesium Sulphate

Question 12

What is the function of tocolytic drugs in labour?

Answer 12

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

Question 13

What is the first line tocolytic drug for preterm labour?

Answer 13

Nifedipine

Question 14

What is the drug class of nifedipine?

Answer 14

Calcium channel blocker

Question 15

What is the second line tocolytic drug?

Answer 15

Atosiban

Question 16

What is the drug class of atosiban?

Answer 16

Oxytocin receptor analogue

Question 17

What is the function of corticosteroids in preterm labour?

Answer 17

To promote the baby’s lung maturity, thus reducing the risk of respiratory distress syndrome after delivery

Question 18

When do we prescribe corticosteroids to preterm labour patients?

Answer 18

They are used in women with suspected preterm labour less than 36 weeks gestation

Question 19

What is the function of magnesium sulphate in preterm labour?

Answer 19

To protect the fetal brain, thus reducing the risk of and severity of cerebral palsy

Question 20

When and how do we administer magnesium sulphate in preterm labour patients?

Answer 20

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

Question 21

At what gestation is magnesium sulphate prescribed to preterm labour patients?

Answer 21

Before 34 weeks gestation