Preterm Labour is generally diagnosed clinically as - Answers regular contractions along with a
change in cervical effacement or dilation or both or presentation with regular uterine
contractions and cervical dilation of at least 2 cm occurring 20 weeks gestation and before 37
weeks gestation
Prematurely-born neonates account for a startling 75-80% of neonatal - Answers morbidity and
mortality
Preterm birth is associated with - Answers cerebral palsy and other long-term health sequelae
Factors that are seen to contribute to the increase in preterm births include - Answers -
increases in multiple births (linked to advanced maternal age and use of reproductive
technologies)
-increases in obstetric interventions
-increases in the use of ultrasound-based estimates of gestational age
Multifactorial etiology of the cause of preterm labour - Answers -behavioural/psychosocial
factors
-neighborhood characteristics
-environmental exposures
-medical conditions
-infertility treatments
-genetics
-biologic factors
The association of what increased the risk of preterm birth and low birth weight - Answers -
poverty
-limited maternal education
-young maternal age
-unmarried status
-inadequate prenatal care
What are four intertwined pathways that influence the risk of preterm labour - Answers -altered
uterine and cervical factors
,-placental ischemia
-inflammation
-stress
The Society of Obstetricians and Gynaecologists of Canada identifies risk factors for preterm
labor as - Answers -multiple gestation
-preterm rupture of membranes
-polyhydramnios
-antepartum hemorrhage
-intra-abdominal surgery
-tobacco or cocaine use
-severe maternal infection
-physical or emotional
-physical or emotional trauma
In multiparae the strongest risk factor for preterm labor is.. - Answers previous preterm delivery
frequently related to a short cervix, bacterial infection or short-interval between pregnancies
Predisposing factors of altered uterine and cervical factors - Answers -multiple gestation
-polyhydramnios
-uterine anomalies
-trauma
-assisted reproductive technology
-Cervical injury
-short interconception interval
-smoking
Why is smoking a predisposing factor to altered uterine and cervical factors - Answers
decreases serum vitamin C levels which is important for collagen formation and strength of the
cervix and sensitivity of the myometrium to oxytocin
Predisposing factors of placental ischemia - Answers -abruptio placentae
, -gestational and chronic health conditions such as diabetes, hypertensive disorders and obesity
-smoking
-alcohol or illicit drug use
-altered nutrition that lets to low body mass index
predisposing factors of inflammation - Answers -bacterial infections including mycoplasma of
the genital tract, pyelonephritis, asymptomatic bacteriuria and pneumonia
-Gonorrhea or chlamydia
-symptomatic BV or trichomoniasis
Predisposing factors to Stress - Answers -High stress level in general
-Domestic Violence
-Single marital status
-socially disadvantaged or low education status
-africal american ethnicity
-long working hours
Muscle contraction and relaxation occur in response to the movement of thick (myosin) and
thin (actin) filaments. The flow of what regulates the movement of the filaments - Answers
calcium
What is most likely the cause of initiation of normal labour - Answers A fetal sign (surfactant
protein A[SP-A]) from the maturing lungs
During pregnancy what is the role of PGI2 (a prostaglandin) - Answers Quiets the uterus by
inhibiting the function gap junctions, by inhibiting release of phospholipase A2 and C and by
blocking movement of calcium into cells.
Production of PGI2 is suppressed during labour secondary to high levels of maternal and fetal
cortisol
What three substances stimulate myometrium contractions by facilitating the movement of
calcium into the smooth muscle so that the muscle can contract and promote cervical ripening -
Answers Thromboxane, PGF 2a, and PGE
Where is estrogen produced - Answers By the corpus lute for the first 2-4 weeks gestation then
the placenta takes over