Notes in OG3.6 Preterm labour and premature rupture of membranes

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Published	10/04/2024	Iatrogenic causes of prematurity include:- {{c1::Preeclampsia}}- {{c1::IUGR}}- {{c1::Maternal disease necessitating delivery}}
Published	10/04/2024	Causes of spontaneous preterm delivery:- {{c1::Preterm labour}}- {{c1::PPROM}}- {{c1::Cervical incompetence}}
Published	10/04/2024	A positive {{c1::fetal fibronectin}} swab between 23 and 35 weeks of gestation indicates ↑ risk of {{c2::preterm delivery}}
Published	10/04/2024	Short cervix is defined as < {{c1::2.5 cm}}
Published	10/04/2024	Patients with a history of preterm delivery should get {{c1::IM progesterone::RX}} weekly
Published	10/04/2024	Patients with prior preterm delivery should have {{c1::serial ultrasound assessment of cervical length::investigation}} and cerclage should be co…
Published	10/04/2024	Offer a choice of either prophylactic {{c2::vaginal progesterone}} or prophylactic {{c2::cervical cerclage}} to women with:{{c1::history of spontaneou…
Published	10/04/2024	Tocolytics MoA → {{c1::↓ intracellular free calcium}}
Published	10/04/2024	Oxytocin responsiveness is {{c1::directly::directly/inversely}} proportional to gestational age
Published	10/04/2024	Management of preterm labour:1. {{c1::Give betamethasone 12 mg IM q24h x 2 doses}}2. {{c1::Tocolysis}}3. {{c1::Transfer to tertiary lev…
Published	10/04/2024	Antenatal corticosteroids should be administered between {{c1::24}} - {{c1::36}} weeks in cases of threatened preterm labour
Published	10/04/2024	Tocolytics:{{c1::Atosiban (oxytocin receptor antagonist)}}{{c1::Nifedipine (Ca2+ channel blocker)}}{{c1::Ritodrine or Terbutaline (beta adrenergic ago…
Published	10/04/2024	Tocolytics:Atosiban is a {{c1::oxytocin receptor antagonist::MOA}}
Published	10/04/2024	Prolonged rupture of membranes refers to rupture of membranes > {{c1::24h}}
Published	10/04/2024	Amnisure tests for placental {{c1::α-microglobulin 1}} in cericovaginal fluid
Published	10/04/2024	↓ amniotic fluid glucose signifies {{c1::infection}}
Published	10/04/2024	Amniotic fluid CRP > 20 mg/L signifies {{c1::infection}}
Published	10/04/2024	PPROM post amniocentesis has a {{c1::better::better/worse}} outcome compared with spontaneous PPROM
Published	10/04/2024	When PPROM occurs start a {{c1::10 day::duration}} course of {{c1::erythromycin 250 mg QDS::drug, dosage, frequency}}
Published	10/04/2024	All cases of PPROM should be delivered by {{c1::37}} weeks
Published	10/04/2024	If fetal compromise or infection with PPROM → {{c1::deliver}}
Published	10/04/2024	PPROM = rupture of membranes < {{c1::37}} weeks
Published	10/04/2024	PPROM occus in {{c1::1-3::range}}% of pregnancies
Published	10/04/2024	Risk factors for PPROM{{c1::infection (chlamydia, GBS, bacteroides)}}{{c1::smoking}}{{c1::placental abruption}}{{c1::previous PPROM}}{{c1::incompetent…
Published	10/04/2024	General principles of PPROM managementadmit at {{c1::24}} weeks gestationdaily {{c1::CTG monitoring}}steroids if between {{c1::24-35+6::range}} weeksp…
Published	10/04/2024	outcomes with PPROMmost commonly {{c1::spontaneous labor in few days}}pregnancy continues with risk of {{c1::infection}}no complications and delivery …
Published	10/04/2024	Risk of recurrence of PPROM = {{c1::20}}%
Published	10/04/2024	Preterm birth = birth between {{c1::24}} and {{c1::36+6}} weeks gestation
Published	10/04/2024	Etiology of preterm birth1/3 due to {{c1::PPROM}}1/3 are {{c1::iatrogenic (medical reasons)}}1/3 are {{c1::idiopathic}}
Published	10/04/2024	risk factors for preterm birthuterine: {{c1::PPROM, polyhydramnios, infection, uterine anomalies::examples}}placental: {{c1::uteroplacental insufficie…
Published	10/04/2024	Antental corticosteroids reduce the incidence of{{c1::NRDS}}{{c1::intraventricular hemorrhage}}{{c1::necrotizing enterocolitis}}{{c1::neonatal death}}
Published	10/04/2024	IV MgSO4 dosing for fetal neuroprotectionloading dose = {{c1::4 gram IV bolus}}maintenance dose = {{c1::2 gram/hour IV infusion}}can give between {{c1…
Published	10/04/2024	GBS prophylaxis = {{c1::benzylpenicillin 3 grams IV}} then {{c1::1.8}} grams every {{c1::4}} hours
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