Preterm labor Definition It is any delivery less

((Preterm labor)) • Definition: • It is any delivery less than 37 completed weeks. • Etiology: • 1 -Infection (chorioamnioitis). • 2 -Placental abruption. • 3 -Urinary tract infection. • 4 -multiple pregnancy. • 5 -Polyhydramnios. • 6 -Cervical incompetence. • Test(1): enumerate The etiological factors that cause preterm labor?

Diagnosis: • 1 -Sever regular uterine contractions. • 2 -Leaking of liquor. • 3 -Cervical dilatation.

Preterm labor should not be stopped if: • 1 -Membrane is ruptured. • 2 -Cervical dilatation is 4 cm or more. • 3 -Intra-uterine infection is established. • 4 -There is placental abruption. • Test(2): At what conditions preterm labor should not be stopped?

Prevention: • 1 -Treat the underlying cause such as: • -infection by antibiotics. • -cervical incompetence by cervical suture. • 2 -Tocolytic agents such as: • -Beta-adrenergic agonist (salbutamol, Terbutaline). • Test (3): How can you prevent preterm labor?

Principles of management: • 1 -The outcome depends on: • a-Gestational age. • b-Condition of the baby at birth. • c-Quality of neonatal care. • 2 -Administration of two doses of dexamethasone to the mother will help to mature the fetal lungs and reduce the risk of hypoxia

• 3 -Fetal assessment by: • a- biophysical behavior index of hypoxia. • b-Fetal Cardiotocography (C. T. G). • c-Ultrasound should be done to: - • *estimate and be sure of fetal gestational age. • *Aliment of fetus. • *Placental localization.

• 4 -Membrane must be left intact throughout the first stage of labor before 32 wk to protect the fetus from bruising and hypoxia that it caused by cord compression. • 5 -Episiotomy done when perineum obstruct delivery between 3237 wk. • 6 - C. S is required when there is a delay or a difficulty in second • stage before 32 wk because internal version or forceps delivery are very traumatic to the fetus at this gestational age. • Test (4): - Explain the management of preterm delivery between 32 -37 wk?