preterm labour Flashcards
when do we consider a birth to be pre term ?
if it occurs between the 24th and 37th week
when do we consider a late miscarriage ?
13 - 24th week
what are the short term complications of preterm labour ?
multi-organ complication respiratory distress sepsis intraventricular hemorrhage necrotizing enterocolitis
what are the long term complications of preterm labour ?
neruodevelopmental
cerebral palsy
chronic lung disease
how is prematurity classified ?
very early preterm : 24-28 weeks
early preterm : 28-32 weeks
late preterm : 34-36 weeks
what are the causes of preterm labour ?
infection
immunological response
placental related problems
polyhydraminous
how does infection cause for the occurence of preterm labour ?
infection is detected by toll like receptors on the cervix which allows for cervical dilatation and effacement , along with the initiation of myometrial contractions
what are the clinical risk factors of preterm labour ?
previous pre term labour sepsis/UTI Twins Uterine abnormalities recurrent APH
how can we make a diagnosis of preterm labour ?
gestational age: 24-37 weeks
regular uterine contractions detected by CTG or manual assessment
PV examination showing cervical dilatation
what investigations can be performed in preterm labour ?
CBC
transvaginal ultrasound
fetal fibronectin
what is the significance of fetal fibronectin ?
has a high negative prediciton
it can rule out labour
absent from 22-35 weeks
what are the preventative measure to avoid preterm birth ?
cerclage
progesterone
what are the indications for cervical cerclage ?
- elective cerclage can be done at 14 weeks for a patient with previous history of PTL
- emergency cerclage can be done at 16-22 weeks for women who have a shortened cervix or present with cervical dilatation 1-2cm max
when is cerclage contraindicated ?
in bleeding/ contractions or ruptured membranes
what is the purpose of giving progesterone to women who are at a high risk of PTL ?
prevents contractions
