How can PTL be predicted?
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1. endocervical length - Women whose cervical length as measured by
transvaginal ultrasound is greater than 30mm in the 2nd and 3rd trimester
are unlikely to give birth prematurely even if they have symptoms of
preterm labor
2. Fetal Fibronectin (fFN), which is a glycoprotein "glue" found in plasma
and produced during fetal life that normally appears in cervical and vaginal
secretions early in pregnancy and then again in late pregnancy
- The presence of fFN during the late second and early third trimesters may
be related to placental inflammation which is thought to be one cause of
spontaneous preterm labor
Spontaneous preterm birth
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Occur following an early initiation of the labor process in the apparent
absence of maternal or fetal illness and make up nearly 75% of all preterm
births in developed countries
When is the fetus considered viable?
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A standard definition is 20 weeks gestation and birth weight of 350, 400, or
500 g, but this varies by state
The limitations on survival outside the uterus when an infant is born at this
early stage are based on CNS function and the oxygenation capability of
the lung
What are some lab tests to consider for miscarriage/spontaneous abortion?
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human chorionic gonadotropin (β-hCG) (pregnancy), hemoglobin level
(anemia), and white blood cell count (infection)
Indicated preterm birth
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, Iatrogenic b/c it occurs as a means to resolve maternal or fetal risk related
to continuing the pregnancy
About 25% of all preterm births in the U.S. are indicated b/c of medical or
obstetric conditions that affect the mother, fetus, or both
Gestational hypertension
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development of hypertension after week 20 of pregnancy in a previously
normotensive woman w/o proteinuria or other systemic findings
How much does total blood volume increase during pregnancy?
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By 40-50%
What medication is used to promote fetal lung maturity when preterm birth is eminent
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Antenatal glucocorticoids (such as betamethasone or dexamethasone). It
stimulates fetal surfactant production
, What is the non-stress test?
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The basis for the NST is that the normal fetus produces characteristic heart
rate patterns in response to fetal movement, uterine contractions, or
stimulation
Tracing is observed for signs of fetal activity and a concurrent acceleration
of FHR
NST results are either reactive or nonreactive
- A reactive NST is considered normal, while a nonreactive test requires
further evaluation
- For a nonreactive test, the testing period is often extended with the
expectation that the fetal sleep state will change and the test will become
reactive
- During this time, vibroacoustin stimulation (VAS) may be used to stimulate
fetal activity
How long does the fetal stage last?
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From 9 weeks (when the fetus becomes recognizable as a human being)
until the pregnancy ends
What does endothelial cell dysfunction cause?
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1. endocervical length - Women whose cervical length as measured by
transvaginal ultrasound is greater than 30mm in the 2nd and 3rd trimester
are unlikely to give birth prematurely even if they have symptoms of
preterm labor
2. Fetal Fibronectin (fFN), which is a glycoprotein "glue" found in plasma
and produced during fetal life that normally appears in cervical and vaginal
secretions early in pregnancy and then again in late pregnancy
- The presence of fFN during the late second and early third trimesters may
be related to placental inflammation which is thought to be one cause of
spontaneous preterm labor
Spontaneous preterm birth
,Give this one a try later!
Occur following an early initiation of the labor process in the apparent
absence of maternal or fetal illness and make up nearly 75% of all preterm
births in developed countries
When is the fetus considered viable?
Give this one a try later!
A standard definition is 20 weeks gestation and birth weight of 350, 400, or
500 g, but this varies by state
The limitations on survival outside the uterus when an infant is born at this
early stage are based on CNS function and the oxygenation capability of
the lung
What are some lab tests to consider for miscarriage/spontaneous abortion?
Give this one a try later!
human chorionic gonadotropin (β-hCG) (pregnancy), hemoglobin level
(anemia), and white blood cell count (infection)
Indicated preterm birth
Give this one a try later!
, Iatrogenic b/c it occurs as a means to resolve maternal or fetal risk related
to continuing the pregnancy
About 25% of all preterm births in the U.S. are indicated b/c of medical or
obstetric conditions that affect the mother, fetus, or both
Gestational hypertension
Give this one a try later!
development of hypertension after week 20 of pregnancy in a previously
normotensive woman w/o proteinuria or other systemic findings
How much does total blood volume increase during pregnancy?
Give this one a try later!
By 40-50%
What medication is used to promote fetal lung maturity when preterm birth is eminent
Give this one a try later!
Antenatal glucocorticoids (such as betamethasone or dexamethasone). It
stimulates fetal surfactant production
, What is the non-stress test?
Give this one a try later!
The basis for the NST is that the normal fetus produces characteristic heart
rate patterns in response to fetal movement, uterine contractions, or
stimulation
Tracing is observed for signs of fetal activity and a concurrent acceleration
of FHR
NST results are either reactive or nonreactive
- A reactive NST is considered normal, while a nonreactive test requires
further evaluation
- For a nonreactive test, the testing period is often extended with the
expectation that the fetal sleep state will change and the test will become
reactive
- During this time, vibroacoustin stimulation (VAS) may be used to stimulate
fetal activity
How long does the fetal stage last?
Give this one a try later!
From 9 weeks (when the fetus becomes recognizable as a human being)
until the pregnancy ends
What does endothelial cell dysfunction cause?
Give this one a try later!
