Preterm Labour Flashcards
1
Q
What are the obstetric indications for preterm labour?
A
Pre-eclampsia
Fetal growth restriction
2
Q
What are indicators of preterm delivery?
A
Cervical length
Fetal fibronectin
3
Q
What are tocolytics?
A
Drugs that stop uterine activity
4
Q
What are some tocolytics?
A
Calcium antagonists - nifedipine
Beta-adrenergics
Magnesium sulphate
Prostaglandin synthesis inhibitors
5
Q
Why are tocolytics used?
A
To delay the onset of labour by 48 hours while the mother is given steroids to mature the fetal lungs
6
Q
What causes premature rupture of the membranes?
A
Idiopathic / Unknown Antepartum haemorrhage Congenital membrane weakness Uterine anomaly Genital tract infection
7
Q
How do you confirm the diagnosis of PROM?
A
Small-for-dates uterus Observed fluid loss per vaginum Characteristic odour Alkaline pH Ferning test Biochemical markers (e.g. fibronectin) Pyridium test - stains urine orange Ultrasound
8
Q
How do you investigate PROM?
A
Maternal vital signs Sterile speculum examination High vaginal swab Cardiotocograph Ultrasound scan Full blood examination C-reactive protein
9
Q
What are complications of PROM
A
MATERNAL Hospitalisation Anxiety / Depression Genital tract sepsis Genital tract haemorrhage Caesarean section
FETAL Prematurity Chorioamnionitis Umbilical cord compression Pulmonary Hypoplasia Limb contractures Neonatal sepsis
10
Q
How is PROM Mx?
A
Home versus hospital Active versus conservative Tocolytics Antibiotics - arthromycin Corticosteroids Amnioinfusion Amniocentesis – L/S ratio – microbiology Oxytocics – syntocinon – prostaglandins
