Preterm labour

Question 1

Define preterm birth

Answer 1

a birth that happens before 37 completed weeks of pregnancy

Question 2

Stages of preterm birth

Answer 2

extremely preterm = <28 weeks
very preterm = 28-32 weeks
moderate to late preterm = 32-37 weeks

Question 3

How does spontaneous preterm birth occur?

Answer 3

preterm pre-labour rupture of the membranes
preterm labour

Question 4

Causes of preterm birth

Answer 4

cervical trauma
previous preterm birth
domestic violence
uterine abnormalities
obesity
ethnicity
smoking

Question 5

What can be done for women with a short cervix to help prevent preterm birth?

Answer 5

progesterone

Question 6

What is cervical cerclage?

Answer 6

a surgical procedure where a stitch is placed around the cervix (the neck of the womb) to help prevent it from opening too early in pregnancy. This procedure is often used to prevent preterm birth and recurrent miscarriages in women with a history of cervical insufficiency

Question 7

How is preterm labour diagnosed?

Answer 7

contractions
cervical changes
rupture of membranes
fancy tests:
- fetal fibronectin
- ACTIM partus
- ACTIM prom
- cervical ultrasound

Question 8

What app gives individualised scores for risk of spontaneous preterm delivery?

Answer 8

QUiPP

Question 8

What is ACTIM prom?

Answer 8

a rapid, point-of-care test used to detect premature rupture of fetal membranes (PROM) in pregnant women. It identifies amniotic fluid in vaginal samples by detecting Insulin-like Growth Factor Binding Protein-1 (IGFBP-1), a protein specific to amniotic fluid. The test is known for its accuracy, even in the presence of blood or other vaginal contaminants, and provides results in minutes

Question 9

If risk of spontaneous preterm labour within 1 week if >5% on quipp app - what should be done?

Answer 9

steroids and admission
transfer to neonatal site

Question 10

What are steroids given for if preterm birth is expected?

Answer 10

reduce death of infant
reduce NEC
reduce sIVH

Question 11

What are magnesium given for if preterm birth is expected?

Answer 11

reduces cerebral palsy

Question 12

When should in utero transfer to a NICU setting be done?

Answer 12

singleton <27 weeks
multiples <28 weeks
<800g estimated foetal weight

Question 13

Who should receive steroids if preterm birth is expected?

Answer 13

women <34 weeks

Question 14

Who should receive magnesium sulphate if preterm birth is expected?

Answer 14

women <30 weeks
(consider between 33+0-33+6 weeks)