Prematurity

Prematurity is defined as foetus that is delivered < 37 weeks. It's classified into:

• Extreme prematurity - < 28 weeks

• Very prematurity - 28-32 weeks

• Moderate to late prematurity - 32-37 weeks

Risk factors:

• Smoking

• Alcohol

• Drugs

• Overweight/Underweight mother

• Multiple pregnancies

• Hx of prematurity

Management

It's very important to delay labour if possible in these situations as each extra week of gestation has a HUGE improvement on prognosis. This can be done prophylactically (before labour starts) with:

• Vaginal progesterone – Suppository put in vagina to discourage labour

• Cervical cerclage – Suture cervix to hold it closed

If premature labour is suspected/confirmed, options include:

• Tocolysis with Nifedipine – Suppresses labour

• Maternal corticosteroids – Improve surfactant production and lung development to reduce risk/severity of respiratory distress upon delivery

• IV Magnesium Sulphate – Protects baby’s brain

  
  

• Delayed cord clamping or cord milking

Complications