Preterm labour and PPROM Flashcards
Definition (in terms of gestational age) of preterm labour
Delivery between 24-37w
At what gestational age do most foetal complications occur
Before 24w
Signs and symptoms of preterm labour
- Increased vaginal discharge
- Mild lower abdominal pain
- Bulging foetal membranes on examination
- Painful uterine contractions
Signs and symptoms of PPROM
- “Popping sensation”
- Gush or steady flow of small amounts of watery fluid
- Painless leakage of fluid from vagina (may see meconium in fluid)
- Absence of steady labour contractions
Most common causes of preterm labour
- idiopathic
- multiple pregnancy
Less common risk factors for preterm labour
- Previous preterm birth
- Previous late miscarriage
- Cervical surgery/ LLETZ
- Antepartum haemorrhage
- Uterine anomalies
- IUGR
- PPROM
- Genital tract infection
- Medical conditions eg renal disease
- Pre-eclampsia
- Antiphospholipid syndrome
On measuring cervical length to assess preterm labour, what length is likely to indicate labour
15mm or less
What concentration of foetal fibronectin is considered positive
50ng/ml or more
If foetal fibronectin is positive, when is preterm birth likely to occur
Within 7-10 days of testing
Who should get prophylaxis for preterm labour
- hx of spontaneous preterm birth/ mid-trimester loss between 16 to 34 weeks
- cervical length <25mm between 16 to 24 weeks
Types of prophylaxis for preterm labour
- vaginal progesterone
- cervical cerclage
Contraindications to cervical cerclage
- Signs of infection
- Active vaginal bleeding
- Uterine contractions
Types of tocolysis
- nifedipine
- oxytocin receptor antagonists
To what group of pregnant women MUST corticosteroids be given
Women between 26 to 33+6 weeks
Why is magnesium sulphate given to mothers going through preterm labour
for neuroprotection of baby
