Preterm Birth, Miscarriage, and Stillbirth

Question 1

List risk factors for a preterm birth

Answer 1

<18 years, >35years, african, south asian, Indigenous, smoker, psychological stress, late/no healthcare in preg, low socioeconomic status, high BMI, infections, uterine abnormalities, multiple, assisted reproduction

Question 2

what is done for someone in threatened preterm labour?

Answer 2

woman is given corticosteroid to help mature fetal lungs, tocolytic given to reduce contractions long enough to give steroid dose, neuroprotectants eg mag sulf to protect fetal brain

Question 3

what are the causes of preterm birth?

Answer 3

infection, clinical decision, cervical length as predictor, hormones, placental pathologies

Question 4

describe RDS as a complication of preterm birth

Answer 4

occurs in 80% infants <27K, most common COD, resp support needed eg CPAP, vent, high/low flow O2, artificial surfactant, ventilator can cause pneumothorax

Question 5

describe GI issues as a complication of preterm birth

Answer 5

tube feeding req <34K as cannot coordinate suckling, swallowing and breathing, intestinal cells not fully developed so cannot absorb all nutrients, necrotizing enterocolitis can develop given ABs PPX

Question 6

describe skin issues as a complication of preterm birth

Answer 6

not developed therefore not protected from infection through skin, temp control and dehydration issues

Question 7

describe CV issues as a complication of preterm birth

Answer 7

patent ductus arteriosus, HOTN, leaky vessels -> oedema, bradycardia

Question 8

define IUGR

Answer 8

baby is small for a pathological reason

Question 9

what is the most common cause for FGR?

Answer 9

placental dysfunction

Question 10

define stillbirth

Answer 10

death of fetus >20K

Question 11

list some causes of stillbirth

Answer 11

SGA, mat disease/accident, uterine abnormalities, HTN, infection

Question 12

define miscarriage

Answer 12

fetal death <20K

Question 13

describe the types of miscarriages

Answer 13

threatened: bleeding <20K usually with no pain, cervix closed and preg cont
inevitable: cervix open, bleeding and pain
complete: pregnancy has ended and both fetus and tissue have been passed
incomplete: some but not all of pregnancy and remaining tissue have been passed, bleeding and infection may develop
blighted ovum: embryo not developed, placenta and empty sac which does not hold fetus, not viable

Question 14

define recurrent miscarriage and its causes

Answer 14

miscarriage occurring 2-3 times in a row, caused by genetic, hormonal, metabolic, uterine anatomical, autoimmune, PCOS, immunological incompat bw partners