Obstetrics: Prematurity and Postmaturity

Prematurity

• Definition: Birth before 37 weeks of gestation
• Risks:
  • Respiratory distress syndrome
  • Hypothermia
  • Hypoglycemia
  • Infections
  • Neurodevelopmental delays
• Causes:
  • Spontaneous preterm labor
  • Premature rupture of membranes
  • Induction of labor due to maternal or fetal complications
• Management:
  • Antenatal corticosteroids to enhance fetal lung maturity
  • Tocolytics to delay labor
  • Neonatal care in a specialized unit

Postmaturity

• Definition: Birth after 42 weeks of gestation
• Risks:
  • Fetal distress
  • Meconium aspiration syndrome
  • Macrosomia (large birth weight)
  • Increased risk of stillbirth
• Causes:
  • Unknown or inaccurate gestational age
  • Fetal growth restriction
  • Maternal hypertension or diabetes
• Management:
  • Induction of labor
  • Close fetal monitoring
  • Antenatal testing to assess fetal well-being

Small for Gestational Age (SGA)

• Definition: Birth weight below the 10th percentile for gestational age
• Risks:
  • Fetal growth restriction
  • Increased risk of stillbirth
  • Neurodevelopmental delays
  • Increased risk of hypertension and cardiovascular disease in adulthood
• Causes:
  • Placental insufficiency
  • Maternal hypertension or diabetes
  • Fetal genetic syndromes
• Management:
  • Close fetal monitoring
  • Antenatal testing to assess fetal well-being
  • Induction of labor if fetal growth restriction is suspected

Large for Gestational Age (LGA)

• Definition: Birth weight above the 90th percentile for gestational age
• Risks:
  • Macrosomia (large birth weight)
  • Trauma during delivery
  • Increased risk of maternal complications (e.g., cesarean section, perineal trauma)
  • Increased risk of childhood obesity and metabolic syndrome
• Causes:
  • Maternal diabetes or obesity
  • Fetal genetic syndromes
  • Excessive fetal growth
• Management:
  • Close fetal monitoring
  • Antenatal testing to assess fetal well-being
  • Induction of labor or cesarean section may be necessary

Respiratory Distress Syndrome (RDS)

• Definition: A condition in which a newborn has difficulty breathing due to immature lungs
• Risks:
  • Prematurity
  • Hypothermia
  • Hypoglycemia
  • Infections
  • Long-term respiratory and neurodevelopmental complications
• Causes:
  • Premature birth
  • Surfactant deficiency
  • Intrauterine growth restriction
• Management:
  • Oxygen therapy
  • Surfactant replacement therapy
  • Mechanical ventilation
  • Close monitoring in a neonatal intensive care unit (NICU)

Prematurity

• Birth before 37 weeks of gestation
• Risks: Respiratory distress syndrome, Hypothermia, Hypoglycemia, Infections, Neurodevelopmental delays
• Causes: Spontaneous preterm labor, Premature rupture of membranes, Induction of labor due to maternal or fetal complications
• Management: Antenatal corticosteroids to enhance fetal lung maturity, Tocolytics to delay labor, Neonatal care in a specialized unit

Postmaturity

• Birth after 42 weeks of gestation
• Risks: Fetal distress, Meconium aspiration syndrome, Macrosomia, Increased risk of stillbirth
• Causes: Unknown or inaccurate gestational age, Fetal growth restriction, Maternal hypertension or diabetes
• Management: Induction of labor, Close fetal monitoring, Antenatal testing to assess fetal well-being

Small for Gestational Age (SGA)

• Birth weight below the 10th percentile for gestational age
• Risks: Fetal growth restriction, Increased risk of stillbirth, Neurodevelopmental delays, Increased risk of hypertension and cardiovascular disease in adulthood
• Causes: Placental insufficiency, Maternal hypertension or diabetes, Fetal genetic syndromes
• Management: Close fetal monitoring, Antenatal testing to assess fetal well-being, Induction of labor if fetal growth restriction is suspected

Large for Gestational Age (LGA)

• Birth weight above the 90th percentile for gestational age
• Risks: Macrosomia, Trauma during delivery, Increased risk of maternal complications, Increased risk of childhood obesity and metabolic syndrome
• Causes: Maternal diabetes or obesity, Fetal genetic syndromes, Excessive fetal growth
• Management: Close fetal monitoring, Antenatal testing to assess fetal well-being, Induction of labor or cesarean section may be necessary

Respiratory Distress Syndrome (RDS)

• A condition in which a newborn has difficulty breathing due to immature lungs
• Risks: Prematurity, Hypothermia, Hypoglycemia, Infections, Long-term respiratory and neurodevelopmental complications
• Causes: Premature birth, Surfactant deficiency, Intrauterine growth restriction
• Management: Oxygen therapy, Surfactant replacement therapy, Mechanical ventilation, Close monitoring in a neonatal intensive care unit (NICU)

This quiz covers the definition, risks, causes, and management of prematurity and postmaturity in obstetrics. Topics include fetal development, maternal complications, and neonatal care.