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Preterm Labor Lin Qi de

Preterm Labor Lin Qi de. Definition Preterm Labor : Labor occurring prior to the completion of 37 weeks ’ of gestation( ≥28 weeks ’ ), or 196-258 days from the last menstrual period (LMP). Etiology Maternal factors: (1) Clinical complication:cardiovascular,

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Preterm Labor Lin Qi de

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  1. Preterm Labor Lin Qi de

  2. Definition Preterm Labor :Labor occurring prior to the completion of 37 weeks’ of gestation(≥28 weeks’), or 196-258 days from the last menstrual period (LMP).

  3. Etiology Maternal factors: (1) Clinical complication:cardiovascular, liver,renal dieases,PIH , severe anemia et al (2) Uterine distortion: Leiomyoma,uterus didelphys , uterus septus, Incompetent cervix and other abnomalities

  4. Fetal and placental factors: (1) Hydramnios (2) Multiple pregnancy (3) PROM (4) Placental abruption (5) Placenta praevia (6) Urinary , intra- amniotics infection

  5. Symptoms and Signs Uterine contraction, (irregulation regulation) Increase or change in vaginal discharge (mucous,watery,light bloody discharge) “Taking up “ of the cervix Progressive dilatation of the os

  6. Preventation • Antenatal care • Treat clinical complication • (3) Operation for the os

  7. Management of PTL The purpose of treating PTL : delay delivery, if possible, until fetal maturity fetal alive no fetal distress no PROM (1) Rest in the bed, lie on left side (2) Prevent RDS:dexamethasone 5mg im 3days to enhance pulmonary maturity

  8. (3) Tocolysis therapy : -adrenergic agents: increase cAMP in cell which decreases free calciun(2-receptors predominate in the uterus ,lung and blood vessels) Prostaglandin synthetase inhibitors: decrease prostaglandin(PG) production Calciun channel blockers: prevent calcium entry into muscle cells

  9. Magnesium sulfate:competes with calcium for entry in to cells • 25%MySO4 + 5%GS 500ml 80-100ml/h(first hour) pay attention to : • The respiratory: more than 16 /min • The knee reflection must be exist • The urine volume must be more than 600ml/24h (25ml/h) • Calcium resistance must be prepared

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