Parturition - Preterm Birth

Question 1

Preterm birth is

Answer 1

Preterm < 37

Very preterm < 32

Question 2

Which factors determine survival for a preterm baby?

Answer 2

Gestation and birth weight

Question 3

Outcomes are good for a preterm baby at ___ weeks and ___g

Answer 3

28-29 weeks

1250 g

Question 4

What are four factors that might cause premature birth?

Answer 4

• Stress
• Bleeding
• Infection
• XS stretch

Question 5

The earlier the labour occurs the more likely it is to have an ____ aetiology

Answer 5

Infectious/inflammatory

Question 6

Why might cervical damage lead to preterm labour?

Answer 6

Weakens the bacteriostatic barrier (operculum)

Question 7

Infection in preterm labour is though to be ascending/descending

Answer 7

Ascending

Question 8

What are some potential consequences of preterm labour?

Answer 8

• Immature foetus
• Malpresentation
• Maternal comorbodities
• Complicated C sections
• Recurrence risk
• Poor outcomes

Question 9

What are the two main causes of iatrogenic preterm birth?

Answer 9

• Maternal disease (preeclampsia)

- Foetal health (IUGR)

Question 10

What is eclampsia?

Answer 10

A grand-mal convulsion due to endovascular inflammation

Question 11

What is the highest risk factor for PTB?

Answer 11

Previous PTB

Question 12

What are non-modifiable risk factors for PTB?

Answer 12

• Maternal age
• Obstetric history
• SES
• Race

Question 13

What are modifiable risk factors for PTB?

Answer 13

• Smoking
• Need for cervical surgery
• Reproductive technologies
• No prenatal care

Question 14

Shorter/longer cervix is associated with higher risk of PTB

Answer 14

Shorter

Question 15

What other markers have been suggested for PTB risk screening?

Answer 15

• Serum biomarkers
• Cervicovaginal fluids
• Cervical length
• Uterine activity

Question 16

Foetal fibronectin is a biologial glue that sits between the ___ and ___

Answer 16

Decidua and chorion

Question 17

After __ weeks pregnancy there is not supposed to be any fibronectin in the vagina

Answer 17

20

Question 18

Of the women with a negative fibronectin test, ___% don’t deliver in 7-10 days

Answer 18

99.5

Question 19

What is the main drug used in tocolysis (suppression of labour)?

Answer 19

Nifedipine (Ca Channel blocker)

Question 20

Which drugs were previously used to suppress premature labour?

Answer 20

• B2 agonist (salbutamol)

- PG agonist (idomethacin)

Question 21

Which antenatal corticosteroid is used to prevent respiratory distress syndrome?

Answer 21

Betamethasone

Question 22

Which drug is administered to premature babies for neuroprotection?

Answer 22

MgSO4

Question 23

MgSO4 is administered in babies under __ weeks ~ ___h before birth

Answer 23

30 weeks

6h before birth

Question 24

When is progesterone gel most effective in suppressing labour?

Answer 24

• Cx length 10-20mm
• 19-23 wks
• Singletons
• Prior STB

Question 25

Which tocolysis interventions may cause harm?

Answer 25

• COX inhibitors
• Antibiotics with intact membranes
• MagSO4
• 17aOH progesterone caporate inj

Question 26

What are two effective interventions to prevent PTB in women with a short cervix?

Answer 26

Progesterone and cervical cerclage