PRETERM BIRTH: ETIOLOGY, DIAGNOSIS, AND MANAGEMENT

A comprehensive set of flashcards summarizing key concepts, definitions, and management practices related to preterm birth, its causes, diagnosis, and therapy, based on detailed lecture notes on the subject.

What defines preterm birth?

Birth that occurs before 37 weeks of gestation (less than 259 days from the first day of the last menstrual period).

What percentage of preterm births are caused by extreme prematurity?

5% of preterm births.

What is the age range for moderate prematurity?

Between 32.0 and 33.6 weeks.

What is the World Health Organization's weight threshold for premature newborns?

Less than 2,500 grams.

What percentage of spontaneous preterm births occurs?

31-40% of preterm births.

What represents a risk factor for preterm labor?

Low socioeconomic status.

What is the main cause of spontaneous preterm labor?

Spontaneous rupture of membranes.

What are the early signs of preterm labor?

Regular contractions and progressive cervical changes.

What indicates that a fetus is experiencing intrauterine growth restriction?

Weight below the 10th percentile for gestational age.

How do beta-agonists function in inhibiting contractions?

By binding to cell membrane receptors and activating adenyl cyclase.

What is the primary purpose of tocolysis?

To delay preterm labor to allow time for corticosteroids to promote fetal lung maturity.

What triggers the need for preterm birth management?

The presence of symptoms of preterm labor or cervical changes.

What is the most common complication in premature infants?

Respiratory distress syndrome.

How often should ultrasound exams be performed in high-risk pregnancies?

Every two weeks.

What are the warning signs of premature labor?

Excessive uterine activity, pelvic pain, cervical changes.

What hormonal treatment is used to hasten fetal lung development?

Corticosteroids.

What are questions asked to guide the use of glucocorticoids?

Max time required for effect, duration of effect, and effectiveness.

What conditions indicate the need to stop tocolytic treatment?

Advanced cervical dilation exceeding 4 cm.

What are the risks associated with tocolytic therapy?

Increased bleeding risk and potential side effects on maternal health.

What is the role of magnesium sulfate in managing preterm labor?

It inhibits contractions but should be administered with caution.

What should be monitored when using beta-agonists in pregnant women?

Maternal heart rate and blood pressure.

When is immediate delivery indicated for preterm infants?

If the fetus shows signs of distress or if cervical changes indicate advanced labor.

What additional risk factors should be assessed in pregnant women with potential preterm labor?

Previous history of preterm birth, infections, or cervical conditions.

Define 'threatened premature labor.'

Clinical symptoms indicating potential for birth before 37 weeks.

What types of infections are associated with increased risk for preterm labor?

Urinary tract infections and bacterial vaginosis.

Which medications are commonly used in tocolytic therapy?

Beta-adrenergics, magnesium sulfate, and calcium channel blockers.

What is a significant fetal concern in pregnancies complicated by CIUR?

Potential for hypoxic injury leading to poor outcomes.

What are the primary management steps for women experiencing preterm labor?

Hospitalization, observation, tocolytics, and monitoring for signs of labor.

What predisposes a woman to higher risk of preterm birth?

Multiple gestations and maternal age extremes.

What defines a high-risk pregnant patient in terms of socioeconomic factors?

Low economic status and inadequate prenatal care.

What is the significance of cervical length in predicting preterm labor?

Shorter cervical length is associated with higher risk of preterm labor.

What are signs of fetal distress in utero?

Abnormal fetal heart rate patterns and reduced fetal movements.

How is gestational age determined during pregnancy monitoring?

Last menstrual period and early obstetric ultrasound.

What constitutes a preterm infant?

An infant born before 37 weeks of gestation.

What correlates with the need for cesarean delivery in preterm labors?

Labor progress complications and fetal distress.

What factors limit fetal growth leading to CIUR?

Genetic, environmental, nutritional deficiencies.

What modifications are made during prenatal visits for high-risk mothers?

Increased frequency of examinations and possibly more detailed imaging.

What potential complications arise from prolonged labor?

Macrosomia and labor distress.

What role do corticosteroids play when given antenatally?

They enhance fetal lung maturity to reduce neonatal respiratory complications.

What is oligohydramnios and its importance?

Decreased amniotic fluid which can compromise fetal well-being.

What ultrasound parameters are critical in assessing fetal growth?

Biparietal diameter, abdominal circumference, femur length.

What is the management for infants with suspected CIUR at birth?

Neonatal monitoring and intervention as necessary based on symptoms.

Define post-term pregnancy.

Pregnancy extending beyond 42 weeks gestation.

What are the risks associated with post-term pregnancies?

Increased risk of stillbirth, macrosomia, and labor complications.

What methods are implemented for monitoring fetal well-being in post-term pregnancies?

Biophysical profile and fetal heart rate monitoring.

How is preterm labor diagnosis made?

Through cervical examination and monitoring contraction patterns.

What does a positive fetal heart rate test indicate?

Fetal well-being and absence of hypoxia.

What should be emphasized in prenatal education for at-risk pregnancies?

Recognition of early signs of labor and when to seek medical help.

What medication is commonly used for enhancing lung maturity in preterm infants?

Corticosteroids like betamethasone.

What is the relationship between maternal diabetes and preterm labor?

Uncontrolled diabetes increases risk for complications, including preterm birth.

What complications are associated with the use of magnesium sulfate?

Maternal hypotension and respiratory suppression.

What physical exam findings may indicate impending labor?

Effacement and dilation of the cervix.

What is the significance of measuring the fetal heart rate?

It assesses fetal distress and overall health.

What are the expected fetal weight gains in a normal pregnancy between 32-36 weeks?

210 to 245 grams per week.

How does pregnancy-induced hypertension impact prematurity?

Increases likelihood of placental insufficiency and preterm birth.

What is the key goal of tocolytic therapy?

To delay labor and allow for fetal development.

What are the indications for administering betamethasone to a pregnant woman?

Risk of preterm delivery before 34 weeks gestation.

What should healthcare providers monitor in mothers receiving tocolytics?

Maternal vital signs, contraction patterns, and fetal heart rate.

How does maternal body position affect placental perfusion?

Lying on the side increases blood flow to the placenta.

What fetal outcomes are associated with post-term pregnancies?

Increased risks of labor complications and birth injuries.

What is the definition of macrosomia?

A newborn with a weight greater than 4,000 grams.

What other assessments complement the ultrasound in tracking fetal growth?

Maternal weight gain and fundal height.

What investigative steps are warranted in high-risk pregnancies?

Frequent monitoring, imaging, and tests for fetal well-being.

What implications does fetal movement monitoring have in pregnancy management?

It informs providers about the fetal condition and potential distress.

What is a characteristic of a healthy cervix in a nulliparous woman?

Closed, firm, and posterior.

What parameter is used to classify CIUR into symmetric and asymmetric?

Timing of the growth restriction relative to fetal development stages.

What is the prevalence of fetal anomalies in cases of CIUR?

22.4% in fetuses diagnosed with CIUR.

What are the immediate birth interventions for extremely premature infants?

Stabilization and supportive care based on gestational age.

What are the key considerations for the timing of delivery in post-term pregnancies?

Maternal and fetal health status and signs of impending labor.

What constitutes a high-risk factor influencing the potential for preterm birth?

Maternal health issues like hypertension and diabetes.

What is the purpose of the biophysical profile in clinical practice?

To assess fetal well-being and predict outcomes.

What clinical signs warrant hospitalization for a pregnant woman?

Signs of preterm labor or complications.

How does gestational age influence neonatal care strategies?

Younger gestational age requires more intensive monitoring and support.

What is indicated by decreased amniotic fluid levels in high-risk pregnancies?

Increased monitoring and evaluation for fetal distress.

What role do genetic factors play in CIUR?

They can significantly impact fetal growth and potential anomalies.

What is the importance of assessing maternal nutrition during pregnancy?

Essential for fetal growth and development.

What intervention is crucial when a fetus is diagnosed with CIUR?

Frequent monitoring and potential early delivery.

What factors must be considered when delaying delivery in a preterm labor situation?

Gestational age, maternal health, and fetal condition.

What should be the standard practice regarding ultrasound in high-risk pregnancies?

Regular evaluations to monitor fetal growth and development.

What maternal condition can lead to an increased risk of CIUR?

Preeclampsia and severe hypertension.

What must be addressed prior to attempting tocolysis?

Confirming effective contraction monitoring and cervical evaluation.

What outcome can fetal heart rate variability indicate?

Fetal well-being or distress.

What is crucial in managing the maternal health of high-risk pregnancy patients?

Multidisciplinary care approach involving obstetricians, neonatologists, and nurses.

What is the expected normal fetal heart rate range?

120-160 beats per minute.

What fetal characteristic is a major marker for postterm pregnancy complications?

Fetal weight and growth status.

What is the significance of fluid management in pregnant women receiving tocolytics?

Helps maintain maternal hemodynamic stability and fetal perfusion.

What medical treatment options are available for CIUR?

Monitoring and potentially improving maternal health and delivering when necessary.

What should commensurate the management of post-term pregnancies with the state's of the fetus?

Expecting proper fetal condition and managing maternal health.

What are visual signs of fetal distress?

Abnormal fetal heart tones and decreased fetal movement.

What uterine conditions may indicate the need for surgical intervention?

Cervical incompetence or significant uterine anomalies.

What informative measures are warranted for pregnant women at risk of preterm birth?

Education on recognizing labor signs and when to seek help.

What educator tips enhance early detection for preterm labor symptoms?

Regular checkups and discussions about symptoms with healthcare teams.

What should accompany any fetal monitoring practices in labor?

Patient education on understanding measurements and outcomes.

What could low fetal heart rate suggest?

Fetal compromise or injury.

What is the main focus in the management of a laboring premature patient?

Controlling contractions and monitoring fetal health.

How can healthcare providers support pregnant patients at risk of premature labor?

By providing information and resources for care and support.

What is essential to identify potential maternal infections related to prematurity?

Timely assessments and interventions based on clinical findings.

How can partners or caregivers assist in the management of high-risk pregnancies?

By offering support through education and helping monitor symptoms.

What can be the consequence of untreated cervical insufficiency?

Increased risk of preterm birth and pregnancy loss.

Why is collaboration between obstetricians and neonatologists crucial?

To ensure comprehensive care for high-risk pregnancies.