Flashcards in Lecture 16 - Preterm Birth Deck (12):
Preterm labour definition?
labour before 37 weeks gestation, very preterm < 32 weeks
Mechanisms of spontaneous preterm birth?
intrauterine stretch (related to CAP, cytokines and prostaglandins, as well as membrane disruption), endocrine maturation, intrauterine hemorrhage, intrauterine infection
fetal genome, uterine strss, fetal HPA axis, abnormal membrane rupture, cervical changes (infection leading to early inflammation
Placentation causes of preterm birth?
growth of fetus, poor attachment (bleeding), progesterone, prostaglandins
Problems of preterm birth?
fetal health, fetal outcomes, maternal co-morbidity, breech risk, complicated c section, recurrence risk
Iatrogenic premature birht?
maternal disease (preeclampsia), FGR; other types being sponataneous
Taking history: risk of preterm birth?
previous PTB, smoking, cervical surgery, maternal disease, antepartum bleeding
Cervix and PTB?
small cervix length leads to greater risk
biological glue beween amniotic and chorion membranes, high concentrations in 1st trimester nad late pregnancy only, normally low in between
suppresses preterm labour, Ca channel and oxytocin receptor blockers
Antenatal corticosteroids (betamethasone)?
prevention of neonatal death from respiratory distress syndrome