Preterm labour Flashcards

1
Q

Preterm birth definition

A

delivery between 24 - 37 weeks

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2
Q

Risk factors for pre term deliivery

A
  1. Previous pre term birth
  2. Multiple pregnancy
  3. Cervical surgery or uterine abnormalities
  4. Pre eclampsiaor IUGR
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3
Q

Acute pre term labour

A

Pre term labour associated with cervical weakness

- early opening of the cervic

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4
Q

Presentation of pre term labour

A
  1. Increased vagina discharge
  2. Mild lower abdominal pain
  3. Bulging membranes on examination
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5
Q

Spontaneous rupture of membrane

A

Spontaneous rupture of the amniotic sack

- common presentation of pre term labour

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6
Q

Ix of pre term labour

A
  1. FBC and CRP
  2. Ultrasound for fetal presentation
  3. Fetal fibronectin assay should be positive
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7
Q

Fetal fibronectin

A

Protein of the amniotic sac

  1. Positive - high likelihood of pre term labour
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8
Q

Transvaginal cervical length

A

> 15 mm unlikely to labour

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9
Q

Management of preterm labour - DRUGS

A
  1. Steroids Betametasone IM (two doses - 24 hours apart)
  2. Tocolysis - nifedipine
    prolongs labour and delivery thus improving gestation
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10
Q

Ix of management of preterm labour

A
  1. Transvaginal cervical length scan

2. Fibronectin assay

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11
Q

Benefit of giving steroids

A
  1. Reduces rate of respiratory distress, intraventricular hemorrhage and neonatal death
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12
Q

Sig of treating bacterial vaginosis

A
  1. Reduce the risk of preterm prelabour rupture of membranes
  2. Low birthweight in women with previous preterm birth
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13
Q

How is bacterial vaginosis treated

A

Clindamycin rather than metronidazole

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14
Q

Methods of preventing preterm labour

A
  1. Treat bacterial vaginosis
  2. Progesterone
  3. Cervical sutures
  4. Reduce number of fetuses in multipregnancies
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15
Q

Progesterone cream

A

In high risk women reduces the recurrence of pre term labour

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16
Q

Cervical sutures

A

To help with cervical weakness.