《妇产科学》课程教学课件（PPT讲稿）6.1 Preterm labor

Preterm labor Luo xiaodong

Preterm labor Luo xiaodong 1

Definition Prematrue labor or delivery Labor spontaneously occurring after 20 (viability 24-28)weeks but before 37 weeks gestation, fetal weight <2500g before 37 and after 28 weeks' gestational age in our country BLeading cause of neonatal morbidity in developed countries

Definition Prematrue labor or delivery Labor spontaneously occurring after 20 (viability 24~28) weeks’ but before 37 weeks’ gestation, fetal weight <2500g before 37 and after 28 weeks’ gestational age in our country Leading cause of neonatal morbidity in developed countries 2

Uterine contractions abdominal tightening lower back pain pelvic pressure Cervical effacement and dilation

Uterine contractions abdominal tightening lower back pain pelvic pressure Cervical effacement and dilation 3

preterm labor other similarly entities cervical incompetence preterm uterine contractions Preterm premature rupture of membrane

preterm labor  other similarly entities cervical incompetence preterm uterine contractions Preterm premature rupture of membrane 4

Complicates 10-15%of all pregnancy cause of neonatal morbidity and mortality

Complicates 10-15% of all pregnancy cause of neonatal morbidity and mortality 5

Etiology Obstetric complications 3Placenta abnormalities >Placenta previa,abruptio placenta BDiabetes,hypertension BPolyhydramnios,oligohydramnios Premature rupture of membrane BMultiple gestation Previous laceration of cervix or uterus BShort interval between pregnancies (<3months)

Etiology Obstetric complications Placenta abnormalities ➢Placenta previa, abruptio placenta Diabetes, hypertension Polyhydramnios, oligohydramnios Premature rupture of membrane Multiple gestation Previous laceration of cervix or uterus Short interval between pregnancies (<3months) 6

Etiology Medical complications Infection >Decidua,fetal membrane,amniotic fluid,urinary tract infection BConization of cervix BHeavy cigarette smoking BAlcoholism or drug addiction Maternal trauma BSevere anemia

Etiology Medical complications Infection ➢Decidua, fetal membrane, amniotic fluid, urinary tract infection Conization of cervix Heavy cigarette smoking Alcoholism or drug addiction Maternal trauma Severe anemia 7

Etiology Surgical complication Any intra-abdominal procedure Genital tract anomalies BIncompetent cervix SUterine anomalies >Bicornuate,unicornuate uterus, subseptate

Etiology Surgical complication Any intra-abdominal procedure Genital tract anomalies Incompetent cervix Uterine anomalies ➢Bicornuate, unicornuate uterus, subseptate 8

Diagnosis Clinical manifestation BUterine contractions >Persistent lower abdominal cramping or discomfortable >Regular,twice during a 10 min, duration is 30 seconds lasting for 30min >Distinction of true and false labor BEffacement and dilation of cervix >2cm or 80%effaced

Diagnosis Clinical manifestation Uterine contractions ➢Persistent lower abdominal cramping or discomfortable ➢Regular, twice during a 10 min, duration is 30 seconds lasting for 30min ➢Distinction of true and false labor Effacement and dilation of cervix ➢2cm or 80% effaced 9

Closed Open cervix cervix Digital examination is the traditional method used to detect cervical maturation,but quantifying these changes is often difficult. 10

Digital examination is the traditional method used to detect cervical maturation, but quantifying these changes is often difficult. 10