Chapter 32 Flashcards
Preterm Birth
Any birth that occurs between 20-37 weeks gestation
Risk factors for spontaneous preterm labor
hx of spontaneous preterm labor, not white, genital tract infection, multifetal gestation, second trimester bleeding, low prepregnancy weight.
what is the only factor show to be definitely associated with preterm labor?
infection
common causes of indicated preterm labor
gestational diabetes, chronic HTN, preeclampsia, previous cesarean birth, seizures, thromboembolism, advanced maternal age, HIV or herpes, obesity
women whose cervical length is greater than ______ are unlikely to have preterm birth.
30 mm
Fetal fibronectin (fFN)
Diagnostic test for preterm labor; collect fluid from the woman’s vagina using a swab; the presence of fFN during the late second and early third trimesters may be indicative of preterm labor coming
Signs and Symptoms of Preterm Labor
contractions occurring more than q 10 min for 1 hour or more, lower abdominal cramping, dull lower back pain, suprapubic pain or pressure, urinary frequency, change in character or amount of usual discharge, rupture of amniotic membranes
Teaching for Preterm Labor
Empty your bladder. Drink 2-3 glasses of water or juice. Lie down on your side for 1 hour. Palpate for contractions. If sx continue, call pcp or go to hospital. If sx go away then resume light activity.
Tocolytics
meds given to stop labor after uterine contractions and cervical change has already occurred.
Maternal contraindications to tocolysis
preeclampsia w/ severe features, bleeding, contraindications to specific tocolytic meds
Fetal contraindications to tocolysis
intrauterine fetal demise, lethal fetal anomaly, nonreassuring fetal status, chorioamnionitis, PROM
Magnesium Sulfate Safety Alert
frequently assess respiratory status, DTR’s, and LOC to monitor for toxic levels; depresses the CNS
Don’t give Nifedipine with
Magnesium sulfate or Terbutaline
Nifedipine (Calcium Channel Blocker) Safety Alert
Change positions slowly!!
Magnesium Sulfate Antidote
Calcium gluconate
When should Indomethacin be given
at less than 32 weeks gestation
Indomethacin
monitor for hemorrhage or signs of bleeding
Terbutaline
monitor blood glucose and potassium levels