Preterm Labor

- is labor that occurs before the end of week 37 of gestation

- it results in the infant�s birth, the infant will be immature
- Maintaining general health during pregnancy is the best preventive measure to
avoid preterm birth
- they diagnose back pain or contractions as nothing more than extremely hard
Braxton Hicks contractions
- with dehydration, urinary tract infection, periodontal disease,
chorioamnionitis, and perhaps large fetal size
- Women who continue to work at strenuous jobs during pregnancy or perform shift
work that leads to extreme fatigue
-trauma this causes may be yet another cause

Common symptoms of early preterm labor

persistent, dull, and low backache; vaginal spotting; a feeling of pelvic
pressure or abdominal tightening; menstrual-like cramping; increased vaginal
discharge; uterine contractions; and intestinal cramping.

THERAPEUTIC MANAGEMENT
-A woman who is in preterm labor is usually first admitted to the hospital and
placed on bed rest to relieve the pressure of the fetus on the cervix.
-External fetal and uterine contraction monitors are attached to monitor FHR and
the intensity of contractions
-Intravenous fluid therapy to keep her well hydrated is begun because although not
well documented, hydration may help stop contractions
-Vaginal and cervical cultures and a clean-catch urine sample are prescribed to
rule out infection

DRUG ADMINISTRATION
-Terbutaline is a drug approved to prevent and treat bronchospasm (i.e., narrowing
of airways) but may be used, off-label, as a tocolytic agent (i.e., an agent to
halt labor)
- it should not be used for over 48 to 72 hours of therapy because of a potential
for serious maternal heart problems.
-Magnesium sulfate, given intravenously, is used primarily to treat preeclampsia
and prevent eclamptic seizures. It was traditionally given to prevent preterm labor
as well.
-Magnesium sulfate for fetal neuroprotection is used prior to 32 weeks to help
prevent cerebral palsy in premature infants
-During the time labor is being chemically halted, therefore, if the pregnancy is
under 34 weeks, a woman may be given two doses of 12 mg betamethasone
intramuscularly 24 hours apart or four doses of 6 mg dexamethasone intramuscularly
12 hours apart.

FETAL ASSESSMENT
- assess overall fetal welfare in the woman who is trying to delay or prevent
preterm labor by assessing the FHR and activity
-