Prematurity Flashcards
(7 cards)
1
Q
What is prematurity?
A
Birth before 37 weeks gestation
2
Q
What is the WHO classification of prematurity?
A
<28 weeks = extreme preterm
28-32 weeks = very preterm
32-37 weeks = moderate to late preterm
3
Q
What can prematurity be associated with?
A
- Smoking
- Alcohol
- Drugs
- Overweight or underweight mother
- Maternal co-morbidities
- Twins
- Personal or family history of prematurity
4
Q
What are the 2 options for delaying birth in women with a history of preterm birth or a cervical length of 25mm or less before 24 weeks gestation?
A
Prophylactic vaginal progesterone - putting progesterone suppository in the vagina to discourage labour
Prophylactic cervical cerclage - putting a suture in the cervix to hold it closed
5
Q
How can the outcome be improved where preterm labour is suspected or confirmed?
A
- Tocolysis with nifedipine - this is a CCB that suppresses labour
- Maternal corticosteroids - can be offered before 35 weeks gestation to reduce neonatal morbidity and mortality
- IV magnesium sulphate - can be offered before 34 weeks and helps protect the baby’s brain
- Delayed cord clamping or cord milking - can increase the circulating blood volume and Hb in the baby
6
Q
What are some issues in early life with prematurity?
A
- RDS - due to immature lungs
- Hypothermia - due to difficulty regulating body temperatures
- Hypoglycaemia - due to limited glycogen stores
- Poor feeding - due to immature reflexes
- Apnoea and bradycardia - due to autonomic nervous system immaturity
- Neonatal jaundice - due to liver immaturity
- Intraventricular haemorrhage
- Retinopathy of prematurity
- Necrotising enterocolitis (inflammation and necrosis of the bowel)
- Immature immune system and infection
7
Q
What are the long term effects of prematurity?
A
- Chronic lung disease of prematurity
- Learning and behavioural difficulties
- Susceptibility to infections, particularly respiratory tract infections
- Hearing and visual impairment
- Cerebral palsy
