Preterm labour Flashcards
Preterm birth definition
delivery between 24 - 37 weeks
Risk factors for pre term deliivery
- Previous pre term birth
- Multiple pregnancy
- Cervical surgery or uterine abnormalities
- Pre eclampsiaor IUGR
Acute pre term labour
Pre term labour associated with cervical weakness
- early opening of the cervic
Presentation of pre term labour
- Increased vagina discharge
- Mild lower abdominal pain
- Bulging membranes on examination
Spontaneous rupture of membrane
Spontaneous rupture of the amniotic sack
- common presentation of pre term labour
Ix of pre term labour
- FBC and CRP
- Ultrasound for fetal presentation
- Fetal fibronectin assay should be positive
Fetal fibronectin
Protein of the amniotic sac
- Positive - high likelihood of pre term labour
Transvaginal cervical length
> 15 mm unlikely to labour
Management of preterm labour - DRUGS
- Steroids Betametasone IM (two doses - 24 hours apart)
- Tocolysis - nifedipine
prolongs labour and delivery thus improving gestation
Ix of management of preterm labour
- Transvaginal cervical length scan
2. Fibronectin assay
Benefit of giving steroids
- Reduces rate of respiratory distress, intraventricular hemorrhage and neonatal death
Sig of treating bacterial vaginosis
- Reduce the risk of preterm prelabour rupture of membranes
- Low birthweight in women with previous preterm birth
How is bacterial vaginosis treated
Clindamycin rather than metronidazole
Methods of preventing preterm labour
- Treat bacterial vaginosis
- Progesterone
- Cervical sutures
- Reduce number of fetuses in multipregnancies
Progesterone cream
In high risk women reduces the recurrence of pre term labour
