Preterm labour Flashcards
What is classed as extremely preterm?
<28 weeks.
When is moderate to late ?
32-37 weeks.
What test should you do for a woman with threatened pre-term labour?
Fetal fibronectin test; protein that keeps sac glued to uterus.
What prophylactic antibiotics should be given in preterm labour?
Erythromycin.
What ways can you delay delivery?
Tocolysis with nifedipine.
Surgical: mcdonald suture in cervix.
When is dexamethasone given?
Up to 34 weeks; promotes surfactant.
When is magnesium sulphate given?
Given in established labour up to 33+6 weeks as a bolus then an infusion as it provides neuroprotection.
What is placenta accreta/.
Placenta embedded in myometrium.
RFs: previous C secretion.
O/E: doughy abdomen.
Section +/- hysterectomy + post delivery contraception
Test to diagnose placenta praevia?
TVUS
MRI excludes placenta accreta
Presentation of uterine rupture?
Intra partum loss of contractions.
Acute abdomen
Shoulder tip pain
Peritonitism
How is post partum haemorrhage defined
Primary within 24 hours.
Secondary 24hours - 6 weeks.
> /= 500mls.
What is a major PPH
> 100mls or signs of CVS collapse.
What are the 4 Ts of PPH?
Tone
Trauma
Tissue
Thrombin
How can you a actively manage the 3rd stage of labour?
IV/IM syntocinon / syntometrine.
Management of minor PPH (500-1000mlO) without clinical shock?
IV access
Bloods etc.
Obs
Give IV WARMED CRYSTALLOID.
