Pre-Term Labour Flashcards
(10 cards)
1
Q
define pre-term labour
A
onsent before 37 weeks
- 2nd commonest cause of perinatal deaths in SA
2
Q
main drivers of perinatal death in preterm labour
A
hyaline membrane disease
intracranial haemorrhage
infections
necrotising enterocolitis
- esp less than 34 weeks
3
Q
causes of pre-term labour
A
IM UC MF PP AI
- infection
- maternal pyrexial illness
- uterine abnormalities
- cervical incompetence
- multiples
- fetal ab
- polyhydramnios
- placenta praevia
- abruption of placenta
- IUGR
4
Q
how to assess if truly pre-term labour
A
- is the patient preterm
- is the patient in labour
- in there an underlying cause
- is the gestation more than 34 weeks – labour can hence proceed
- is there a contraindication to tocolysis if less than 34 weeks
5
Q
contraindications to tocolysis
A
> IUD
IUGR
fetal distress
lethal congenital abnormality
CA
Pre-eclampsia
APH
cervix less than 6cm dilated
6
Q
what investigations should be done?
A
- Urine MC/S
- CTG
- USS
- High vaginal swab
7
Q
how to manage a pt of <34 weeks OR EFW < 2kgs
A
- Refer
- Admit
- Bed rest
- CTG and monitor
- Contractions timing
- Tocolyse
- Administer BMZ
- Treat cx
- Review after 48 hrs
8
Q
why is BMZ given?
A
- enhances feta lungs development
- prevents intraventricular haemorrhage
- prevents necrotising enterocolitis
9
Q
name tocolytic drugs
A
- Ca-channel blockers
- B2 adrenergic agents
- prostaglandin antagonists
- oxytocin antagonists
- see table
10
Q
delivery process of the pre-term infant
A
- refer
- epidural and anlagesia
- keep checking longitudinal lie
- consider assisted delivery
- have resus and specialist on standby
- give BMZ
