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Dr Damulira Adam
Objectives
– Preterm Labour:
• regular uterine contractions accompanied by progressive
cervical dilatation and/or effacement after viability but at
less than 37 completed weeks.
Definition
– Preterm Birth:
• any birth regardless of weight occurring after viability but
before 37 completed weeks from the first day of last
menstrual period (LMP)
• increased perinatal morbidity and mortality is associated
with birth < 34 weeks
Cont..
• Epidemiology
• 7% labours are preterm
• 30% babies born at 24wks survive (UK)
• 80% babies born at 28wks survive (UK)
Etiology
• APH
• preterm pre-labour rupture of membranes
(PPROM)
• multiple pregnancy
• polyhydramnios
• incompetent cervix
• uterine anomaly
• fetal anomaly
Cont..
• Idiopathic
• Chorioamnionitis
• Systemic dz (pyelonephritis)
• Drug abuse - cocaine
• Trauma to abdomen
• procedures – e.g amnioscentesis
Additional Risk Factors
• idiopathic
• infection
• polyhydramnios
• cervical incompetence
• uterine abnormality
• following cervical cerclage or amniocentesis
• trauma
• previous cervical surgery (conization)
• Other ( smoker, stress, lifestyle, nutrition, drugs)
Diagnosis of PROM
• fetal/neonatal infection
• maternal infection
• umbilical cord compression/prolapse
• caesarean section rate