Preterm Birth Guidelines Quiz

Questions and Answers

What should be done for women with multiple pregnancies who are at risk of preterm birth?

Consider the use of adjunct prediction tests exclusively

Do not provide any corticosteroids under any circumstances

Only provide repeat doses of corticosteroids

Administer a single course of corticosteroids as per guidelines (correct)

In which situation should repeat doses of corticosteroids not be administered to women with multiple pregnancies?

When preterm birth is imminent within 24 hours

When there is a risk of preterm birth present

If there is no identified risk of preterm birth (correct)

If a single course has already been given

What adjunct prediction tests are suggested for identifying imminent delivery in women with spontaneous preterm labor?

Routine ultrasound scans every week

Assessing uterine contractions frequency

Maternal blood pressure monitoring

Fetal fibronectin or transvaginal cervical length measurements (correct)

What is recommended for women at gestational age 23+0 to 23+6 weeks when preterm birth is expected within the next seven days?

They should receive a single course of corticosteroids only after a full review Signup and view all the answers

Which of the following is NOT a guideline for administering corticosteroids to women with multiple pregnancies?

Repeat doses should be provided regardless of risks Signup and view all the answers

Why should a single course of corticosteroids be considered at a gestational age of 23+0 to 23+6 weeks?

To improve neonatal outcomes when preterm birth is imminent Signup and view all the answers

What is the recommended approach for women at risk of early preterm birth regarding corticosteroids?

Use a two dose course of antenatal corticosteroids. Signup and view all the answers

Which corticosteroid is typically recommended for a two dose course?

Betamethasone or Dexamethasone. Signup and view all the answers

In which scenario should repeat antenatal corticosteroids be considered?

After the initial two dose course if the risk of preterm birth remains. Signup and view all the answers

What is a key consideration when determining repeat corticosteroid dosing?

The duration since the last dose of corticosteroid. Signup and view all the answers

What should be considered when selecting corticosteroids for repeat administration?

The potential benefits versus risks of steroids. Signup and view all the answers

Which of the following is NOT a consideration for antenatal corticosteroid use?

Fetal heart rate monitoring methods. Signup and view all the answers

What is the potential impact of antenatal corticosteroids on neonatal outcomes?

Reduces the incidence of respiratory distress syndrome. Signup and view all the answers

What is a common misconception about the use of repeat antenatal corticosteroids?

They should only be used if the first dose was beneficial. Signup and view all the answers

What is the primary purpose of administering antenatal corticosteroids to women prior to birth?

To improve neonatal outcomes Signup and view all the answers

At what gestational age are antenatal corticosteroids considered standard care for women at high risk of preterm birth?

Less than 35 weeks Signup and view all the answers

What is the recommended administration method for antenatal corticosteroids?

Intramuscular injections Signup and view all the answers

What is the indication for a repeat dose of corticosteroids?

If ongoing risk of preterm birth is greater than seven days and less than 14 days after the initial course Signup and view all the answers

Which major morbidity can antenatal corticosteroids help reduce in preterm infants?

Respiratory distress syndrome Signup and view all the answers

What is a potential benefit of administering repeat doses of corticosteroids according to the evidence?

Decreased mortality and morbidity in infants Signup and view all the answers

What critical factor regarding corticosteroids remains uncertain according to the guidelines?

Best type, dose, frequency, and mode of administration Signup and view all the answers

What evidence is noted about follow-up studies of children who received repeat corticosteroids?

No adverse effects were noted in follow-up studies Signup and view all the answers

Study Notes

Purpose of Policy

Recommendations provided for the use of antenatal corticosteroids to enhance neonatal outcomes.

Guideline Management Principles and Goals

Antenatal steroids recommended for women at high risk of birth before 35 weeks gestation.
A single repeat dose may be given if the risk of preterm birth persists, up to 32 weeks and 6 days.

Background

Administration of intramuscular corticosteroids significantly lowers mortality and morbidity in very and moderately preterm infants.
Benefits include reduced incidence of respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis.
Standard care established for women at high risk of delivering before 35 weeks gestation since 1990.
Meta-analyses show neonatal advantage from repeat doses of corticosteroids for women at ongoing risk of preterm birth (7 to 14 days post-initial course) without adverse effects noted in long-term follow-up.

Definitions

Clarification of terms related to antenatal corticosteroid use.

Summary of Guidelines

Detailed protocols for two-dose courses of antenatal corticosteroids in women at risk of early preterm birth.

Multiple Pregnancies

Single and repeat corticosteroid doses should follow general guidelines for women at risk of preterm birth.
Avoid use in women with multiple pregnancies without other preterm risk factors.
Utilize prediction tests (like fetal fibronectin or cervical length assessment) to identify those likely to deliver imminently.

Specific Gestational Age Recommendations

At gestational age 23 weeks and 0 days to 23 weeks and 6 days, consider a single corticosteroid course if preterm birth is expected within the week, following a thorough review and planning for active intervention.

Further Actions and Documentation

Reference associated guidelines for managing threatened and active preterm labor (PTL).
Include flowcharts for visual guidance on corticosteroid administration.

Additional Considerations

Various indications and best practice points regarding corticosteroid use in antenatal care.

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Description

Test your knowledge on guidelines for pregnant women at risk of early preterm birth. Learn about the recommended procedures and best practices.