Chapter 32: Labor and Birth Complications Flashcards
preterm labor is any birth between ____ and ____ weeks
20:0 ; 36:6
very pre-term
<32 weeks
moderately pre-term
32-34 weeks
late preterm
34:0-36:6 weeks
which is more dangerous, preterm birth or low birth weight?
preterm birth because fetal body systems have not fully developed yet
low birth weight is considered:
<2500 grams at birth
spontaneous preterm births account for what percentage of preterm births?
75%
indicated (purposeful) preterm births account for what percentage of preterm births?
25%
_______ is the only definitive cause of spontaneous preterm labor
infection of the genital tract
a decrease in progesterone might cause:
spontaneous preterm labor
what is a fetal fibronectin test
if NO fetal fibronectin is present in the vaginal discharge then that mother has less than a 1% chance of having a preterm labor
preterm labor can be prevented in some women by administering prophylactic __________
progesterone
short length cervix (15mm-20mm) might cause:
preterm labor
if mom is at risk for preterm labor, the following four steps should be taken:
- transfer to a hospital that is equipped to care for preterm babies
- administer antibiotics to prevent group B strep
- administer antenatal glucocorticoids
- administer magnesium sulfate in women less than 32 weeks
what does magnesium sulfate do when given to mothers in preterm labor before 32 weeks
prevent cerebral palsy
three major signs of preterm birth are:
1.
2.
3.
- contractions
- vaginal discharge
- pain
5 things to do immediately if preterm labor is suspected: 1. 2. 3. 4. 5.
- stop what you are doing immediately
- lie down on your side
- drink two-three glasses of water or juice
- wait 1 hr
- call provider or go to birthing facility of symptoms worsen
- if symptoms go away, inform hcp at next visit
- call hcp if symptoms return
are women who are suspected of preterm labor allowed to have sex?
NO
very low birth rate is defined as:
weighing less than 1500 grams at birth
extremely low birth weight is defined as:
weighing less than 1000 grams at birth
_______ is the number one cause of neonatal and number two cause of infant mortality in the US
prematurity
_______ are medications administered to help prolong gestation when preterm labor has started
tocolytics
two examples of tocolytics include:
1.
2.
- beta adrenergic (ritodrine & terbutaline)
2. magnesium sulfate
what is the most commonly used tocolytic medication
magnesium sulfate
therapeutic range of magnesium sulfate
4.75-5.8 mg/dL
what reverses magnesium sulfate toxicity
calcium gluconate
commonly used NSAID to prolong gestation in preterm labor
Indomethacin
calcium channel blocker given to prolong gestation in preterm labor
Nifedipine
nifedipine should never be given with _______ or _______
magnesium sulfate; beta adrenergic (terbutaline)
if patient is given Nifedipine, the nurse must instruct her to:
get up slowly, don’t change position too quickly because of orthostatic hypotension
_________ is an IM medication that accelerates fetal lung maturity by stimulating fetal surfactant production
antenatal glucocorticoids
magnesium sulfate should be given to women who are at least ______ weeks but less than ______ weeks
24;32
magnesium sulfate should not be given longer than ____ if birth has not occurred
24 hours
dosing for magnesium sulfate includes;
4 g given IV for 30 minutes followed by 1g/hr
________ is the spontaneous rupture of the amniotic sac prior to the onset of labor at any gestational age
pre-labor rupture of membranes
__________ is the spontaneous rupture of the amniotic sac before 3 weeks
preterm pre-labor rupture of membranes
________ is a major risk factor of preterm pre-labor rupture of membranes
infection of urogenital tract
_______ is the most common maternal complication of preterm pre-labor rupture of membranes
chorioamnionitis
_______ is a bacterial infection caused by preterm PROM
chorioamnionitis
