Preterm Labour and PPROM part Flashcards
What gestation is classified as premature and reference?
Birth Before 37/40wks
BMJ Best Practice, 2015
What is classified as extreme prematurity and reference?
<28/40wks
BMJ Best Practice, 2015
What is classified as Severe prematurity and reference?
28-31/40wks
BMJ Best Practice, 2015
What is classified as moderate prematurity and refereance?
32-33/40wks
BMJ Best Practice, 2015
What is classified as Late preterm and refereance?
34-36/40wks
BMJ Best Practice, 2015
What is deemed to be the age of viability?
the age of viablity is 24/40wks, but if the baby is less than 23/40wks yet is estimated to be 400g and more, and is showing signs of life then resuscitation is often attempted.
Name the 8 behavioural and environmental risk factors of prematurity?
Lifestyle – smoking, recreational drugs, alcohol ◦Nutrition ◦Weight (BMI <19.8 or >30) ◦Physically demanding work ◦Prolonged periods of standing and/or shift/night work ◦Domestic violence/physical abuse ◦Abdominal injury ◦Stress
Name the three types of demographics that can determine the prediction of prematurity.
Low socioeconomic status
◦<17 years of age or >35 years of age
◦Ethnicity
Name 7 medical risk factors
infection (accounts for up to 40% of occurrences)
◦Diabetes
◦Renal Disease
◦Cardiovascular disease
◦Hypertension
◦Antiphospholipid Syndrome ◦Psychiatric disorders
Name the nine reproductive risk factors of preterm
PROM ◦Placental abruption/APH ◦Inadequate antenatal care ◦Multiple pregnancy ◦Cervical abnormalities ◦Uterine abnormalities ◦Polyhydramnios ◦IUGR ◦History of preterm labour
Name the ways of managing preterm.
cervical cerclage or vaginal progesterone ◦Measurement of cervical length or fetal fibronectin ◦Antenatal corticosteroids ◦Nifidipine ◦Magnesium Sulphate ◦Fetal Monitoring ◦Cold clamping ◦(Antibiotics – covered in PPROM
What would u do as a part of labour care?
Follow the NICE intrapartum care guideline)
◦Stop tocolysis
◦Borderline viability – early MDT involvement consulting with parents
◦Continuous CTG??
◦Spontaneous labour is often very rapid even for primigravida
What would u do as a part of delivery?
Cesarean section vs vaginal(Think of ◦Gestation◦Presentation◦Fetal condition) ◦Instrumental delivery? ◦Episiotomy? ◦Avoidance of delay on the perineum ◦Active resuscitation
What are maternal complications of preterm?
Infection ◦Haemorrhage ◦Psychological trauma ◦DIC (secondary to either infection or haemorrhage) ◦Maternal death
What are fetal complications of preterm?
RDS, poor temperature control,
poor glucose control
◦Infection
◦Death
Name the different things You would have to do as a midwife when in a preterm scenario
prevention where possible
◦Risk assessment
◦Early detection
◦Assisting medical staff and liaising with MDT
◦Labour care
◦Visit to SCBU if possible
◦Preparation for delivery (numbers of people present, likely condition of baby)
◦Assist with resuscitation
◦Keep baby warm (neo wrap, hat, radiant heaters)
◦Encourage breast milk expression
◦Emotional support for family
Name the 6 complications of PPROM
Prematurity ◦Sepsis ◦Pulmonary hypoplasia ◦Cord prolapse ◦Malpresentation ◦?APH
What is PPROM and define it
Preterm Pre-labour Rupture Of Membranes. This is spontaneous rupture of membranes before 37weeks and before the onset of labour.
Name 5 of the associated factors of PPROM.
Preterm Lifestyle – smoking, recreational drugs, alcohol ◦Nutrition ◦Weight (BMI <19.8 or >30) ◦Abdominal injury ◦Stress History of PPROM Multiple pregnancy
Name the methods of management of PPROM
Corticosteriods – as for preterm labour ◦Antibiotics ◦Inpatient vs home care ◦Timing of delivery ◦Method of delivery
What is amnioinfusion?
The process of instilling isotonic liquid in the uterine cavity
