Labor & Birth Complications -- Week 4 Flashcards
Preterm Labor (PTL)
KNOW THIS!!!!!
Regular contractions with a change in cervical effacement or dilation or both or presentation with regular uterine contractions & cervical dilation of at least 2 cm
Preterm Birth
KNOW THIS!!!!!
A birth that occurs between weeks 20 & 36 6/7 weeks of gestation; more dangerous than low birth weight
- Very Preterm: < 32 weeks
- Moderately Preterm: 32 - 34 weeks
- Late Preterm: 34 - 36 6/7 weeks
75% of all births in the US are preterm
What is considered preterm birth?
KNOW THIS!!!!!
Birth between 20 weeks & 36 6/7 weeks
Define Very Preterm, Moderately Preterm, & Late Preterm Births
KNOW THIS!!!!
- Very Preterm: < 32 weeks
- Moderately Preterm: 32-34 weeks
- Late Preterm: 34 - 36 6/7 weeks
What percentage of all births in the US are preterm?
75%
Low Birth Weight
KNOW THIS!!!!!
< 2500 grams (5.5 lbs); intrauterine growth restriction (IUGR)
What is Intrauterine Growth Restriction (IUGR)?
KNOW THIS!!!!
limited nutrients from the placenta to the baby
- can result in low birth weight – < 2500 grams (5.5 lbs)
Spontaneous Preterm Birth
Spontaneous preterm births occur following an early initiation of the labor process absent of fetal or maternal illness
- 75% of preterm births
Causes: pathogens, infection, abnormalities, allergic reaction
Risk Factors: socioeconomic status
Indicated Preterm Birth
KNOW THIS!!!!!
Occurs as a means to resolve maternal or fetal risk that is often related to the continuation of the current pregnancy
- diabetes, HTN, preeclampsia, etc.
Fetal Fibronectin Test (fFN)
KNOW THIS!!!!!
used to predict who will NOT go into preterm labor (< 1%)
- glycoprotein “glue” found in plasma & produces during fetal life
Signs of Preterm Labor
KNOW THIS!!!!!
- Vaginal discharge change / increase
- Pelvic pressure
- Mild abdominal cramps
- Constant dull back pain
- Regular contractions / ruptured membrane
What medications are used for fetal lung maturity?
KNOW THIS!!!!!
antenatal glucocorticoids (ACT)
Premature Rupture of Membranes (PROM)
Spontaneous rupture of the amniotic sac & loss of amniotic fluid before labor begins
Preterm Premature Rupture of Membranes (PPROM)
KNOW THIS!!!!!
Ruptured membranes in preterm pregnancy (before 37 weeks)
- preceeded by infection (chorioamniotitis)
Chorioamnionitis
KNOW THIS!!!!!
Bacterial infection of the amniotic cavity (major complication for mothers)
S/S: fever, tachycardia, uterine tenderness, foul odor amniotic fluid
Tx: IV antibiotics & birth of the fetus / GBS (group beta strep) test
S/S of Chorioamnionitis
KNOW THIS!!!!!
- Fever
- Tachycardia
- Uterine tenderness
- Foul odor amniotic fluid
Postterm Pregnancy
birth at > 42 weeks (0.5% of mothers)
- increases maternal morbidity, dysfunctional labor, abnormal growth, shoulder dystocia, meconium stained fluid
Dystocia (dysfunctional labor)
KNOW THIS!!!!!
Difficult labor for any reason
abnormal contractions; hypertonic uterine dysfunction; latent / active; protraction (slower); arrest (cease); anesthesia; precipitous labor (< 3 hours); intrauterine pressure catheter (IUPC); tachysystole; pelvic structure; cervical edema; fetal causes (anomalies, CPD, malposition, multifetal); psychological (anxiety)
the 5 Ps = challenges