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Prof . Hazem Elshahawy - Incidence of PTB continous to increase, account for 75% of all neonatal mortality and morbidty - Def : PTB involves uterine contractions <5 minutes apart and cervical changes ( usually >1 cm diltation or cervical shortening by U.S). -Contractions that do not meet that frequency or contractions without cervical change several hours after uterine activity starts are called uterine irritability, irregular contractions, Braxton Hicks tractions, or false labor, but have no effect on the cervix are never called pretermlabour Signs and symptoms of preterm labor Increase or change in vaginal discharge
and/or bleeding (sudden gush or
constant slow leak of fluid from the
• Regular contractions that may or may
not be painful
• Period-like or stomach cramps (with or
• Constant ache in the lower back
• Pressure in the pelvic area (sensation
that the baby is pushing down) Preterm labour can result in the birth of a
premature baby. The closer a baby is born to
the due date, the better it is for the baby’s
health. Premature babies account for 60 to
70% of all infant deaths in babies born
without birth defects. how to prevent ? Preterm labour cannot always be prevented
or stopped if it starts. Pregnant women can
follow these measures to reduce the risk of
• See your doctor or midwife early and
regularly for prenatal appointments
• Keep track of reproductive health and
•Get lots of rest
• Avoid alcohol, tobacco and illicit drugs
• Learn about the signs of preterm labour
• Avoid vaginal douching
• Find healthy ways of dealing with stress
• Maintain good oral health Babies born prematurely may needtreatment in special care facilities and bemore likely to have problems with.
:• Temperature instability• Breathing (Respiratory DistressSyndrome [RDS])• Eating• Infections• Jaun Risk factors maternal -age at the upper and lower end of the reproductive years - Maternal height and weight - low BMI - surgical induced abortion -during pregnancy -multiple pregnancy
- fertility medication
-placental problems diagnosis U.S cervix fetal
fibronectin mangment Initial :- -Evaluation and Labs -bed rest -treat under lying causes -Labor precautions
Limit maternal Narcotics for pain control
Complete cervical dilation may be less than 10 cm
Elective ceserean <36 weeks offered in some settings Corticosteroids indication