Preterm labor

What is preterm labor?

Preterm labor is the onset of regular uterine contractions that cause cervical effacement and/or dilation before 37 weeks of gestation.

At what gestational age is a birth considered preterm?

A birth is considered preterm if it occurs between 20 weeks and 36 weeks + 6 days of gestation.

What is late preterm birth?

Late preterm birth occurs between 34 weeks and 36 weeks + 6 days of gestation, accounting for 75% of preterm births in the U.S.

What are some demographic risk factors for preterm labor?

Demographic risk factors include African-American race, low socioeconomic status, limited education, and late entry into prenatal care.

How does BMI affect preterm labor risk?

A BMI less than 19.6 or greater than 30 increases the risk of preterm labor.

Name a lifestyle-related risk factor for preterm labor.

Smoking or substance abuse.

What pregnancy-related conditions can increase the risk of preterm labor?

Previous preterm birth, bleeding of uncertain origin, multifetal gestation, or uterine anomalies.

What is fetal fibronectin (fFn), and how is it used?

Fetal fibronectin is a glue-like glycoprotein found in cervical/vaginal secretions indicating inflammation and preterm labor risk.

What is considered a short cervical length, and how is it measured?

A cervical length of less than 2.5 cm, measured via ultrasound, indicates a higher risk of preterm labor.

What are some strategies to prevent preterm birth?

Preconception counseling, progesterone supplementation, smoking cessation, and maintaining a healthy weight.

What is the purpose of tocolytics?

Tocolytics are medications used to delay labor temporarily, allowing time for interventions.

How does magnesium sulfate help in preterm labor?

Magnesium sulfate relaxes the uterus and provides neuroprotection for the baby.

What is the antidote for magnesium sulfate toxicity?

Calcium gluconate.

How does nifedipine (Procardia) work in preterm labor?

Nifedipine is a calcium channel blocker that relaxes the smooth muscles of the uterus.

What are the side effects of terbutaline (Brethine)?

Side effects include tachycardia, palpitations, chest discomfort, tremors, and nausea.

What is the role of betamethasone in preterm labor?

Betamethasone is a corticosteroid that helps mature the baby's lungs by stimulating surfactant production.

At what gestational age is betamethasone most commonly administered?

Between 24 and 36 weeks of gestation.

What is cervical insufficiency?

Cervical insufficiency is the painless dilation of the cervix in the second trimester, leading to preterm birth.

How is cervical insufficiency treated?

A cerclage is used to reinforce the cervix.

What is PPROM?

Preterm premature rupture of membranes (PPROM) is when the amniotic sac ruptures before 37 weeks of gestation.

What is the most common complication of PPROM?

Chorioamnionitis, a bacterial infection of the amniotic cavity.

How is PPROM managed?

Management includes hospitalization, monitoring for infection, corticosteroids, and antibiotics.

What are the risks associated with multifetal pregnancies?

Risks include anemia, preterm labor, placenta previa, placental abruption, and congenital malformations.

Why do women over 35 have a higher chance of multifetal pregnancies?

Due to age-related fertility treatments and increased use of assisted reproductive technologies.

What is hyperemesis gravidarum?

Severe, excessive vomiting during pregnancy leading to weight loss and dehydration.

How is hyperemesis gravidarum treated?

Treatment includes IV fluids, antiemetics, vitamin B6, and Unisom.

Is bedrest recommended for preterm labor?

No, there is no evidence to support bedrest as a prevention method, and it may cause strain.