Term
|
Definition
| labor that occurs btwn 20-37wks |
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|
Term
| leading cause of infant mortality: |
|
Definition
|
|
Term
|
Definition
| contractions w changes in cervix (dilation) |
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Term
| 5 long term effects of preterm birth: |
|
Definition
1. neurologic impairment
2. developmental delay
3. visual impairment
4. hearing impairment
5. chronic lung dz |
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|
Term
| most common cause of preterm labor: |
|
Definition
| spontaneous preterm labor (36%) |
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|
Term
|
Definition
premature preterm rupture of membranes
causes preterm labor |
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|
Term
| 5 causes for prematurity: which 3 are linked? |
|
Definition
1. preterm labor
2. PPROM
3. incomplete cervix
4. medical indications
5. antepartum hemmorrhage
1,2,3are linked |
|
|
Term
| ACOG guidlines for elective deliveries: |
|
Definition
1. 20 wks if fetal heart tone w non-electric stethescope OR 30 weeks by doppler
2. 36 wks since +hCG
3. CRL @ 6-12wks>39wks +/-7d
4. serial U/S 12-20wks suuports 39wks +/- 10days |
|
|
Term
|
Definition
1. maternal age <18,>40
2. previous preterm deliv
3. substance abuse
4. infections
5. multiple gestation |
|
|
Term
|
Definition
1. documented uterine contractions (4 per 20min)
2. 80% effaced or >2cm dilated |
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|
Term
| interpretations of fetofibrinectin: |
|
Definition
(-)probably won't deliver within 2 wks
(+)18% chance of delivery wn the week |
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|
Term
| preterm labor management: 6 |
|
Definition
1. cervical assessment
2. correct underlying problem (UTI,BV)
3. bed rest (lateral decubitis)
4. hydration
5. monitor contractions/cervix
6. start ampicillin/draw labs |
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|
Term
| there is a cervical US performed at 28 wks: if the cervix is < ___ then monthy US is indicated |
|
Definition
|
|
Term
| define tocolytic therapy: |
|
Definition
| medications used to stop pretem labor |
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|
Term
| 4 rx classes for tocolytic therapy: |
|
Definition
1. CCB (nifedipine)
2. MgSO4
3. prostaglandin inhibitor(indimethacin)
4. beta-mimetics |
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|
Term
| what is the purpose for tocolytic therapy? |
|
Definition
| need to try and stop delivery for 2 days so you can get steroids to baby |
|
|
Term
| 2 steroids and dosing used for preterm labor babies: |
|
Definition
1. betamethasone: 2 doses of 12mgIM q24h
2. Dexamethasone: 4 doses of 6mgIM q12h |
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|
Term
| 6 contraindications to tocolytic therapy: |
|
Definition
1. preeclampsia
2. severe bleeding from pathology
3. chorioamnionitis
4. IUGR(intrauterine growth restriction)
5. fetal anomalies incomp c life
6. fetal demise |
|
|
Term
|
Definition
| premature rupture of membranes = water breaking before onset of labor |
|
|
Term
|
Definition
1. preterm birth
2. chorioamnionitis
3. cord compression
4. RDS (resp dys syn)
5. abruptio placentae
6. malpresentation |
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|
Term
| in 95% of PROM cases labor starts within: |
|
Definition
|
|
Term
|
Definition
| microscopic presentation of amniotic fluid; confirms rupture of membranes |
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|
Term
| management of PROM >36wks: |
|
Definition
1. favorable cervix induce after 6-12h
2. non-favorable cervix induce >24h |
|
|
Term
|
Definition
1. ferning
2. L:S
3. Phosphatidylinositol
4. Phophatidylglycerol
5. gram stain/C&S of amiotic fluid |
|
|
Term
|
Definition
1. corticosteroids
2. prophylactic abx |
|
|
Term
|
Definition
1. deliver if FLM can be documented
2. deliver if evidence of infection
3. corticosteroids for immature FL
4. abx for expectant mgt |
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|
Term
| define: expectant management |
|
Definition
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|
Term
|
Definition
|
|
Term
| 4 maternal complications of GDM: |
|
Definition
1. 50% chance of developing DM wn 10yrs
2. preeclampsia
3. C-section
4. HTN |
|
|
Term
| 5 fetal complications of GDM: |
|
Definition
1. Macrosomia
2. hypoglycemia
3. obesity in childhood
4. Resp. Distress syn
5. shoulder dystocia |
|
|
Term
|
Definition
1. diet & exercize
2. if not controlled with #1 then insulin or other DM med
3. weekly fetal monitoring beginning at 32wks
4. 2hr GTT @ 6-8wks postpartum |
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