MCN Flashcards
What is the definition of Premature Cervical Dilatation?
Cervix that dilates prematurely and therefore cannot hold a fetus until term
Previously termed an incompetent cervix
What are the risk factors for Premature Cervical Dilatation?
- Increased maternal age
- Congenital structural defects
- Trauma to the cervix, such as might have occurred with a cone biopsy or repeated D & Cs
What are the causes of Premature Cervical Dilatation?
- Previous surgery on the cervix
- Damage during a difficult birth
- Congenital cervical or uterine anomalies
- Previous trauma to the cervix
- Infection
- Increased uterine volume
What are the signs and symptoms of Premature Cervical Dilatation?
- Painless dilatation
- Presence of show
- Increased pelvic pressure
- Followed by rupture of the membranes & discharge of the amniotic fluid
- Uterine contractions
What is a positive history indicating Premature Cervical Dilatation?
Repeated, relatively painless spontaneous second trimester abortions
What assessments are used for Premature Cervical Dilatation?
- Serial pelvic exam
- Ultrasound
What are the nursing diagnoses for a woman with Premature Cervical Dilatation?
- The woman will be able to explain incompetent cervix, treatment alternatives and implications for future child bearing
- The woman and her caregivers will be able to detect possible complications early and manage them appropriately
- The woman will be able to deal with pregnancy loss
What is a key component of planning for Premature Cervical Dilatation?
Therapeutic Management
What is a common therapeutic management technique for Premature Cervical Dilatation?
Cervical Cerclage
When is cervical cerclage typically placed?
At approximately weeks 12 to 14, once a sonogram confirms that the fetus of a second pregnancy is healthy
What are the two techniques for cervical cerclage mentioned?
- McDonald technique
- Shirodkar-Barter technique
What conditions would make a woman ineligible for a cerclage?
- Increased irritation of the cervix
- The cervix has dilated 4cm
- Membranes have ruptured
What nursing management should be implemented for a woman with Premature Cervical Dilatation?
- Reporting painless bleeding
- Encourage strict bedrest
- Sexual relations can be resumed in most instances after this rest period
What should be done after cerclage surgery?
Remain on bed rest (perhaps on a slight or modified Trendelenburg position) for a few days
What are some possible complications of cerclage that should be taught to the patient?
- The amniotic membranes may rupture when the cerclage is placed
- The uterus may become irritated, starting labor
- The placenta or uterus may become infected
- The cervix may be damaged if contractions tear the cerclage out
What are the expected outcomes for a woman with Premature Cervical Dilatation?
- The woman understands the importance of contacting her physician immediately if her membranes rupture or if labor begins
- The woman understands the means to prevent possible complications
