Labor and Birth Complications Flashcards
Preterm Labor
Postterm Labor
Preterm Premature Rupture of Membranes
(PPROM)
Risk Factors for Preterm Labor
Medical History
Risk Factors for Preterm Labor
Obstetric History
Risk Factors for Preterm Labor
Present Pregnancy
- Short cervical lengnth or cervical insufficiency
- Uterine distention
- Preeclampsia/eclampsia and/or gestational diabetes
- Poor nurtion and/or anemia during pregnancy
- time between pregnacnies < 1 year
- Preterm PROM
- Infections
- STIs
- Chorioamniotis
- UTIs
- Low pregnacny weight gain
- Fetal or placental abnormalies
Risk Factors for Preterm Labor
Demographics/Lifestyle
Diagnostic methods for Preterm labor
Fetal Fibronection level
Salivary estriol
Cervical length
Subjective data
Nitrazine or Fern test
Who should be considered at risk for preterm labor
Signs and Symptoms of preterm Labor
-
Uterine activity
- Uterine contractions occuring more frequently than ever 10 minutes persiseting for 1 hour or more
- Uterine contractiosn may be painful or painless
-
Discomfort
- Lower abdominal cramping, similar to gas pains; may be accompanined by diarrhea
- Dull intermittent low back pain
- Painful menstrual like cramps
- Suprapubic pain and pressure
- Pelvic pressure or heaviness; feeling that the “baby is pushing down”
- Urinary frequency
What to Do If Symptoms of Preterm Labor Occur
- Empty your bladder
- Drink two or three glasses of water or juice
- Lie down on your side for 1 hour
- Palpate for contractions
- In symptoms continue, call your doctor or go to the hospital
- If symptoms go away, resume light activity, but not what you were doing when the symptoms began
- If symptoms return go to the hospital
- if any of the following occur call your health care provider immediately:
- Uterine contractions every 10 minutes or less for 1 hour or more
- Vaginal bleeding
- Odorous vaginal discharge
- Fluid leaking from vagina
Nursing Diagnosis For Preterm Labor
Nursing Interventions for Preterm Labor
Activity restrictions
What are Tocolytics
Goal of tocolytic therapy
Commonly Used Tocolytics
Magnesium Sulfate
What does it do
Magnesium Sulfate Toxcitiy Warning Signs
What drug should you give for Magensium Sulfate toxicity
Ritodrine and Terbutaline
What should the maternal heart rate be when recieving Terbutaline
Nuring Care for Patients receiving Tocolytic Therapy
Nifedipine
Calcium channel blocker nursing alert
Indomethacin
Antenatal Glucocorticoids
Premature Rupture of Membranes likely results from
How is PROM or PPROM diagnosed?
What is the most common maternal complication of Preterm PROM
Less Common Serious Maternal Complications of PROM
Fetal Complications from PPROM are ripmarily related to what
Care Management of PROM
Education after preterm PROM
Chorioamnionitis
(intrapartum infection)
- Bacterinal infection of the amniotic cavity
- Major casue of complications for both mother and newborns
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Dystocia
(Dysfunctional Labor)
Causes of dystocia
- Ineffective uterine contractions (powers)
- Alterations in the pelvic structure (passage)
- Fetal casues (passenger)
- abnormal presentation or position
- anomalies
- excessive size
- more than one fetus
- Maternal position during labor and birth
Dysfunctional labor is suspected when
Factors that increase a womans risk of dystocia
Abnormal uterine acitivty can be describe ad being
Hypertonic Contractions
Treatment options for Hypertonic Contractions
Hypotonic Uterine Contractions
- Contractions become weak and ineffective or stop all together
- Intrauterine pressure during the contraction is usually less than 25 and is insufficent for progress of cervical effacement and dilation
- CPD and malposition are common casues
- Increased risk of infection
- May be related to over streched over used uterus
- medications
- Maternal age
- Cervical ridgity
- Can lead too
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Precipitious Labor
Fetal Causes of Dystocia
Cephalopelvic disproportion (CPD)
Malposition
Measures to facilitate rotation of the fetal head
Malpresentation
Breech Position
- Frank breech -hips flexed knees extended
- Complete breech- hips and knees flexed
- Footling breech- one or both feet present before butt
- Associated with multifetal gestation, preterm birth, fetal or maternal maomalies, hydramnios, plioghydraminios
- Labor prologed becasue the butt doesnt cause effective cervical dilation like the head
- Risk of prolabose cord
- meconium stained amniotic fluid is a risk
- Assess FHR
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Face and brow presentation
Shoulder presentation
(transverse lie)
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