premature labor

PREMATURE LABOR : 

PREMATURE LABOR

Premature labor is labor that occurs before the 37th week of pregnancy due to uterine contractions that cause the cervix to open earlier than normal. Can happen for unknown reasons but it is associated w/ dehydration, UTI, and chorioamnionitis. : 

Premature labor is labor that occurs before the 37th week of pregnancy due to uterine contractions that cause the cervix to open earlier than normal. Can happen for unknown reasons but it is associated w/ dehydration, UTI, and chorioamnionitis.

Risk Factors Multiple Gestation Polyhydramnios PROM Incompetent cervix Placenta previa/ abruptio placenta Previous preterm labor Women who continue to work at strenuous jobs that can result to extreme fatigue African- American race Adolescents Women who receive inadequate prenatal care. : 

Risk Factors Multiple Gestation Polyhydramnios PROM Incompetent cervix Placenta previa/ abruptio placenta Previous preterm labor Women who continue to work at strenuous jobs that can result to extreme fatigue African- American race Adolescents Women who receive inadequate prenatal care.

S/Sx: -persistent, dull, low backache -vaginal spotting -a feeling of pelvic pressure or abdominal tightening -menstrual-like cramping - increased vaginal discharge -uterine contractions -intestinal cramping : 

S/Sx: -persistent, dull, low backache -vaginal spotting -a feeling of pelvic pressure or abdominal tightening -menstrual-like cramping - increased vaginal discharge -uterine contractions -intestinal cramping

Dx Test: Analization of vaginal mucus- presence of fetal fibronectin (protein produced by trophoblast cells.) -Sonography- for shortened cervix. : 

Dx Test: Analization of vaginal mucus- presence of fetal fibronectin (protein produced by trophoblast cells.) -Sonography- for shortened cervix.

Mgt. -Admit to the hospital immediately. -Place px on bed rest to relieve pressure of the fetus on the cervix.(lie on left or right side) -Have the px to hold baby ASAP -Assess : fetal age, onset, duration of preterm labor, amniotic membranes, uterine activity; fetal position, presentation and station of fetus; cervical dilatation, effacement, softening. -Keep px hydrated: IV therapy & inc. fluid intake -Monitor V/S , fetal heart rate and uterine contractions. : 

Mgt. -Admit to the hospital immediately. -Place px on bed rest to relieve pressure of the fetus on the cervix.(lie on left or right side) -Have the px to hold baby ASAP -Assess : fetal age, onset, duration of preterm labor, amniotic membranes, uterine activity; fetal position, presentation and station of fetus; cervical dilatation, effacement, softening. -Keep px hydrated: IV therapy & inc. fluid intake -Monitor V/S , fetal heart rate and uterine contractions.

-Avoid activities that could stimulate labor, such as nipple stimulation. -Administer Magnesium sulfate (DOC) - Administer tocolytic agents (drugs that can halt labor) such as: 1) Calcium channel blockers: Nifedipine (Procardia) 2) Prostaglandin antagonist: Indomethacin (Indocin) 3) Beta- sympathomimetic drugs: Ritodine hcl (Yutopar), Terbutaline (Brethine) -Administer an antibiotic: group B streptococcus prophylaxis. : 

-Avoid activities that could stimulate labor, such as nipple stimulation. -Administer Magnesium sulfate (DOC) - Administer tocolytic agents (drugs that can halt labor) such as: 1) Calcium channel blockers: Nifedipine (Procardia) 2) Prostaglandin antagonist: Indomethacin (Indocin) 3) Beta- sympathomimetic drugs: Ritodine hcl (Yutopar), Terbutaline (Brethine) -Administer an antibiotic: group B streptococcus prophylaxis.

-Administer Steroids if pregnancy <34 wks. Betamethasone: 2 doses of 12 mg, IM, 24 hrs apart Dexamethasone: 4 doses of 6 mg, IM, 12 hrs apart. : 

-Administer Steroids if pregnancy <34 wks. Betamethasone: 2 doses of 12 mg, IM, 24 hrs apart Dexamethasone: 4 doses of 6 mg, IM, 12 hrs apart.

N. DX. Fear r/t uncertain outcome of pregnancy. Pain r/t labor contractions. Situational low self-esteem r/t inability to carry pregnancy to term. Risk for fetal injury : 

N. DX. Fear r/t uncertain outcome of pregnancy. Pain r/t labor contractions. Situational low self-esteem r/t inability to carry pregnancy to term. Risk for fetal injury