premature labour

Apr 16th, 2015
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PREMATURE LABORLabor occurring prior to the completion of 36 weeks' gestationIncidence/Prevalence in USA: 8-12% of all births in the USASIGNS AND SYMPTOMS:- Regular uterine contractions, with or without pain, continuing for 1 hour- Dull, low backache, pressure, or pain- Intermittent lower abdominal or thigh pain- Intestinal cramping, with or without diarrhoea or indigestion- Change in vaginal discharge- Contractions every 5-10 minutes- Dilatation of the cervix greater than 1 cm- Effacement of the cervix more than 50%- Signs of ruptured membranes (pH paper turns blue; fern positive)CAUSES:- Infections (UTI, pyelonephritis, pneumonia)- Subclinical chorioamnionitis (intra-amniotic infections from aerobes, anaerobes, mycoplasma, and ureaplasma)- Uterine abnormalities (incompetent cervix, leiomyomata; septa, diethylstilbestrol DES exposure)- Over-distention (by multiple gestation or hydramnios)- Premature rupture of membranes- Trauma- Iatrogenic- Abruption of placenta- Immunopathology (e.g., antiphospholipid antibodies)RISK FACTORS:- Prior preterm delivery- Multiple gestation- Bacterial vaginosis- Three or more first-trimester abortions- Previous second-tri

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