8 - Obs - Preterm Delivery - Background, Complx + Aetiology Flashcards Preview

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Flashcards in 8 - Obs - Preterm Delivery - Background, Complx + Aetiology Deck (7):
1

Delivery ?-?wks. Most important pre-?wks – neonatal risks ?. Before ?wks, labour is tantamount to a ?, though v few do survive at ?wks. ?-?% deliveries are preterm.
Preterm deliv can be result of: ? labour, or usually at ?
gestations can be ? (delivery expedited by obstetrician due to ?).

24-37
34
higher
24
miscarriage
23
5-8
spont
later
iatrogenic
risk

2

Risks of preterm ? w gestation so threshold for ?
lowers. Most commonly ? – delivery is only ?, preg affected at ?wks would have high risk if continued to ?.

lessen
induction
preeclampsia
cure
28
term

3

Complications

Neonatal: Prematurity -> 80% of ???? occupancy, 20% ? mort and 50% ? ? . Other long term morb inc chronic ?
disease, ? and minor disability common. Earlier gestation = ? risk to fetus. 24wks: 1/3rd babies ? , 1/3rd ?. 32wks: both risks %.

Maternal: ? freq ass w preterm labour and can -> severe maternal illness and ?, ?
is common. ? ? more commonly used.

NICU
perinatal
cerebral palsy
lung
blindness
increased
die
handicapped
<5
infection
postnatally
endometritis
C/S

4

RF's
Many, prev ?, lower ? ?, extremes of mat ?, ? inter-preg interval, maternal disease eg ?
failure, ?? and thyroid disease, preg compx inc ? or ????, ? fetal gender, high ?, ???s and vaginal ? eg BV, prev ? surgery, ? preg, uterine abnormality/?, UTI, ?, ? fetal abnormality and ???.

Hx
social class
age
shorter
renal
DM
preeclampsia
IUGR
male
Hb
STI
infection
cervical
multiple
fibroids
polyhydramnios
congen
APH

5

Mechanisms
? = castle, ? = wall holding defenders in.

Too many defenders: ? preg, 20% ? deliver pre34wks, ?wks is mean deliv time for ?. ?
has same effect, prob mediated by incr ?.

Defenders jump out: Fetal ?
response, ? preterm labour more common when fetus at ? eg pre-eclampsia and IUGR, or if ?. Also placental ? often followed by ?. ? preterm deliv can improve upon this.


uterus
cervix

multi
twins
34
triplets
polyhydramnios
stretch

survival
spont
risk
infection
abruption
labour
iatrogenic

6

Mechanisms

Castle design poor: Uterine abnormalities eg ? or congen abnormalities.

Wall is weak: ? incompetence = painless ? preceding some preterm deliveries.
Some follow ? for CIN or ?, or multiple ? of the cervix. Or no RFs.

Enemy get around walls: ???
and poor ? health are RFs.

fibroids

cervical
dilatation
surgery
cancer
dilatations

UTI
dental

7

Mechanisms

Enemy knock down walls: ?
implicated in 60% preterm deliveries, often ?. Chorioamnionitis, ? liquor, neonatal ? and endometritis after ? = all manifestations. ?? = RF, ???, trichomonas, ? and commensals also indicated. Effects dependent on ? and infection.

infection
subclinical
offensive
sepsis
delivery
BV
GBS
chlamydia
cervix

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