Preterm labour

Question 1

what are risk factors for preterm labour?

Answer 1

smoking 
multiple pregnancies 
polyhydramnios 
short cervix
foetal genetic abnormality 
infection - chorioamnionitis, UTI 
placental abruption 
maternal health (diabetes, pre eclampsia)
extremities of age

Question 2

if a woman goes into preterm labour, what measures will you take to manage the patient and the foetus?

Answer 2

tocolytics to prevent labour for up to 48 hours (give steroids times to work)

steroids (foetal lung development)

magnesium sulphate if < 32 weeks (reduce risk of cerebral palsy)

Question 3

if a woman has a short cervix, what preventative measure can be done to prevent preterm labour?

Answer 3

if a woman has a previous preterm labour, < 24 weeks and cervical length < 25mm then she can have cervical cerclage

Question 4

if a woman has a history of pre term labour, what preventative measures can be taken to try and reduce risk of pre term labour in future pregnancy?

Answer 4

smoking cessation
good diet
regular antenatal care
spacing of pregnancy (< 6 months and > 59 months associated with increased risk)

progesterone suppositories 
hydroxyprogesterone caproate (start during 2nd trimester up to 37 weeks)

Question 5

what is cervical cerclage?

Answer 5

procedure carried out on women with a short cervix (<25mm) who are at increased risk of pre term labour

stitching up the cervix and then remove them at 37 weeks

Question 6

If a patients has PROM, what medication is given to prevent infection?

Answer 6

10 days course erythromycin