prematurity

Question 1

When should resus of a premature baby be carefully considered?

Answer 1

<500 grams
24 weeks gestation
Outcomes are poor

Question 2

Classifications of prematurity

Answer 2

• Under 28 weeks: extreme preterm
• 28 – 32 weeks: very preterm
• 32 – 37 weeks: moderate to late preterm

Question 3

Associations with prematurity

Answer 3

• Social deprivation
• Smoking
• Alcohol
• Drugs
• Overweight or underweight mother
• Maternal co-morbidities
• Twins
• Personal or family history of prematurity

Question 4

Which women do yuo consider delaying birth in

Answer 4

History of prem birth
Cervical lenth <25mm before 24 weeks

Question 5

Options for delaying birth

Answer 5

Prophylactic vaginal progesterone - supposityr
Prophylactic cervical cerclage - suture in cervix to hold it closed

Question 6

Options for improving premature labour

Answer 6

Tocolysis with nifedipines
Maternal corticosteorids
IV mg sulphate
Delayed cord clmaping or milking

Question 7

Issues in early life with prematurity

Answer 7

• Respiratory distress syndrome
• Hypothermia
• Hypoglycaemia
• Poor feeding
• Apnoea and bradycardia
• Neonatal jaundice
• Intraventricular haemorrhage
• Retinopathy of prematurity
• Necrotising enterocolitis
• Immature immune system and infection

Question 8

Long term effects of prematurity

Answer 8

• Chronic lung disease of prematurity (CLDP)
• Learning and behavioural difficulties
• Susceptibility to infections, particularly respiratory tract infections
• Hearing and visual impairment
• Cerebral palsy

Question 9

What does nifedipine do to delya labour?

Answer 9

CCB 0 supressess ;abour

Question 10

When are maternal corticosteroids offered

Answer 10

before 25 weeks - reduces neonatal morbiditiy and mortality

Question 11

When is IV mg sulphte offered

Answer 11

before 34 weeks gestation - help protect babys brain

Question 12

What does delayed cord clamping allow?

Answer 12

Increase circulating blood volume and Hb in baby