Preterm labor

PRETERM BIRTH By gestational age: • Moderate preterm: 32 to <37 weeks • Late preterm: 340/7ths to 366/7ths weeks • Very preterm: 28 to <32 weeks • Extremely preterm: <28 weeks .

PRETERM BIRTH By birth weight : • Low birth weight (LBW): <2500 grams • Very low birth weight (VLBW): <1500 gram s • Extremely low birth weight (ELBW): <1000 grams .

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Spontaneous unexplained preterm labor with intact membranes .REASONS FOR PRETERM DELIVE RY • There are four main direct reasons for preterm births in the United States: 1. Delivery for maternal or fetal indications in which labor is induced or the infant is d elivered by prelabor cesarean delivery 2.

Idiopathic preterm premature rupture of membranes(PPROM) 4. Twins and higher-order multifetal births.3. .

Cervical dilatation greater than 1 cm 3.Preterm labor(1997) 1. . Contractions of four in 20 minutes or eig ht in 60 minutes plus progressive change in the cervix 2. Cervical effacement of 80 percent or grea ter.

clinical manifestations • • • • • Menstrual-like cramping Mild. irregular contractions Low back ache Pressure sensation in the vagina Vaginal discharge of mucus. mucus plug. or slightly bloody (ie. which may b e clear. pink. bloody show) .

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GBS swab • Labs : fFN • US: cervical length < 25 mm .Diagnostic workup/studies • Pelvic exam: sterile speculum.digital.

• Sterile speculum and digital exam to eval uate cx dilation • Collect fFN swab • GBS swab • Sterile vaginal exam to directly assess cer vix(must be after fFN collected!) .

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95% do not deliver in 14 days • Not reliable with vaginal bleeding.Fetal Fibronectin • BM peptide present in amniotic membran es • If negative . recent (<24h) intercourse or vaginal exam .