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Maternity Exam 1 > Labor and Birth Complications > Flashcards

Labor and Birth Complications Flashcards

1
Q

What is preterm labor?

A

Regular uterine contractions that produce cervical change prior to 37 weeks gestation

  • 34-36 6/7 weeks = late preterm birth/infant
  • < 34 weeks = preterm birth/infant
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2
Q

What are signs and symptoms of preterm labor?

A
  • uterine contractions
  • low back pain
  • pelvic pressure
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3
Q

What are risk factors for preterm labor?

A
  • dehydration
  • diabetes
  • hypertensive disorders
  • infection
  • multiparity (has more than one child)
  • multiple gestation (twins/triplets)
  • obesity
  • stress
  • substance abuse
  • trauma
  • polyhydramnios (excess amniotic fluid)
  • prior preterm birth
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4
Q

Describe preterm labor nursing care.

A
  • Patient education on signs and symptoms of PTL
  • Screen for infections (VS, urinalysis, labs)
  • Hydration (PO or IV depending on protocol)
  • Rule out UTI
  • Fetal monitoring
  • Palpate abdomen for contractions and/or tenderness
  • Bed and/or pelvic rest
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5
Q

What is PROM?

A
  • Premature Rupture of Membranes
  • Spontaneous rupture of the amniotic membranes before the onset of labor (sometimes called pre-labor ROM)
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6
Q

What is PPROM?

A

preterm premature rupture of membranes

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7
Q

What does PROM/PPROM cause increased risk for?

A

Increased risk of infection as barrier to external environment is gone

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8
Q

How to treat PROM/PPROM?

A
  • Treatment based on gestational age, could include antibiotics and prolonged bed rest
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9
Q

Describe nursing care for PROM/PPROM.

A
  • Teaching
  • Vital signs
  • Fetal surveillance
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10
Q

What happens during Umbilical Cord Prolapse?

A
  • Cord slips ahead of presenting part and can lead to significant compression to fetus
  • May see abnormal fetal heart rate patterns (decelerations)
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11
Q

When can Umbilical Cord Prolapse happen?

A

Can occur anytime during labor with or without ruptured membranes

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12
Q

What are risk factors for Umbilical Cord Prolapse?

A
  • breech or transverse lie (abnormal fetal position)
  • non-engaged presenting part
  • polyhydramnios
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13
Q

How to manage Umbilical Cord Prolapse?

A
  • Trendelenburg
  • elevate presenting part off the cord
  • emergency c/s
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14
Q

What happens during Shoulder Dystocia?

A
  • Head is delivered vaginally, anterior shoulder can’t pass under pubic arch
  • May see head “turtle”
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15
Q

What are risk factors for Shoulder Dystocia?

A

macrosomia (bigger baby: greater than 4000 grams)

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16
Q

How to manage Shoulder Dystocia?

A
  • widen pelvis
  • McRoberts (legs flexed tightly towards abdomen)
  • suprapubic pressure (pressure above the pubic bone)
  • rotation
  • hands and knees
17
Q

What risks does Shoulder Dystocia pose to the infant?

A
  • broken clavicle
  • brachial plexus injury
  • neurological compromise
  • death
18
Q

What risks does Shoulder Dystocia pose to the birthing parent?

A
  • perineal trauma
  • psychological trauma
19
Q

What is Magnesium Sulfate used for in high-risk pregnancies?

A
  • Given IVPB to prevent seizures in patients with preeclampsia
    • Reduces the risk of intraventricular hemorrhage leading to cerebral palsy
  • Can temporarily slow or stop preterm labor
  • Neuroprotection for preterm baby
20
Q

Magnesium Sulfate nursing considerations?

A
  • Recommended for gestational ages < 33 weeks
  • Loading dose followed by maintenance infusion for 24 hrs
  • Double verification drug
  • Patient education on side effects
21
Q

What are Antenatal steroids used for in high-risk pregnancies?

A

Stimulates fetal surfactant production (helps baby’s lungs mature)

22
Q

What’s a commonly used Antenatal steroid and how is it given?

A
  • Typically betamethasone
  • 2 IM doses 24 hour apart
23
Q

Antenatal steroids indication?

A

preterm labor between 24-36 weeks (sometimes 34 weeks is upper limit)

24
Q

What is Oxytocin (Pitocin) used for?

A
  • Used to prevent or manage postpartum bleeding (1st-line)
  • Used for induction of labor
    • Stimulates uterine contractions
25
Q

When is Pitocin used?

A
  • It’s used before delivery and postpartum
  • Used for induction of labor
26
Q

What route is Pitocin given?

A
  • Almost exclusively IV or IVPB but can be given IM (for Postpartum bleeding or prevention)

Maternity Exam 1 (5 decks)

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