ST.

PAUL UNIVERSITY DUMAGUETE

North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

A case study on a Pre-term Labor Intrauterine Fetal Death

In partial fulfillment of the requirements in NCM-112a

Submitted by:

CG P. Bambo

Christian Davis D. Regis

Laurence R. Zerna

Kyra Rhae Ibale

 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

Submitted to:

Mrs. Sheryl Liz Regis, RM, RN

 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022
 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

MEDICAL MNGT

Blood Transfusion

A blood transfusion is a frequently performed procedure where you

receive blood through an intravenous (IV) line into one of your
blood vessels. There are two conditions that may warrant a blood
transfusion during pregnancy. These include the development of
severe anemia close to your due date, or hemorrhaging at some
point during your pregnancy[CITATION Blo21 \l 1033 ].

HBsAG

This test can detect the actual presence of the hepatitis B virus
(called the “surface antigen”) in your blood. If a person tests
“positive,” then further testing is needed to determine if this
is a new “acute” infection or a “chronic” hepatitis B infection.
A positive HBsAg test result means that you are infected and can
spread the hepatitis B virus to others through your blood.[CITATION
Hep21 \l 1033 ]

Urinalysis

A urinalysis is a simple test that looks at a small sample of

your urine.  It can help find problems that need treatment,
including infections or kidney problems.  It can also help find
serious diseases in the early stages, like kidney
disease, diabetes, or liver disease. 

Dilation and Evacuation (D & E)

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 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

Dilation and evacuation (D&E) is one of the methods available for

a second-trimester abortion. A D&E is done to completely remove
all of the tissue in the uterus for an abortion in the second
trimester of pregnancy[ CITATION Mar20 \l 1033 ].  It usually includes a
combination of vacuum aspiration and the use of surgical tools
(such as forceps). D&E usually takes less than 30 minutes [ CITATION
Rom21 \l 1033 ].

Induced labour

Women who chose to have their labour induced after the late death
of their unborn baby in the womb (24 weeks pregnant or more)
should be offered a drug called mifepristone (which is taken by
mouth as a tablet), followed by a drug that acts like the natural
hormones that kick-start labour (called a prostaglandin).
Misoprostol is a type of prostaglandin and is an option at this
point. It is a type of drug called a prostaglandin that is known
to cause contractions of the womb, so it is not used for
preventing or treating ulcers in women who are pregnant.
Prostaglandins should usually be inserted into the vagina as a
gel, tablet or pessary [CITATION Mis13 \l 1033 ].

NURSING MNGT

 Intrauterine fetal death is when an unborn baby (fetus) dies

inside the womb before birth. This is described as 'late' when it
happens in a woman who is 24 weeks pregnant or more. Most
stillbirths happen before a woman goes into labor. Some
stillbirths may happen during labor and birth. Stillbirths may be

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 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

caused by infections in the mother, or placenta; complications

during pregnancy like preeclampsia, preterm labor or trauma;
Problems with the baby such as birth defects, fetal growth
restriction, or genetic conditions; Problems with the placenta
such as blood clots, swelling, or separation of the placenta from
the wall of the uterus; Problems with the umbilical cord such as
a knot that prevents oxygen and blood flow to the baby; Problems
during labor and delivery that prevent blood and oxygen from

reaching the baby,

Nurses or student nurses should instruct the patient not to have

sexual intercourse for 1-2 weeks or as advised by the doctor.
This will help the patient avoid infection, we can reduce the
risk of infection by avoiding exposure to bacteria vaginally such
as by having sex too soon. We need to educate the patient that
they can return to their normal activities on 1-2 days after the
uterus has cleared. Even though they can already go back to their
day to day activities, the patient still needs to avoid strenuous
activities or exercises for 1-2 weeks. They should let their body
recover and to reduce the risk of side effects, that is why they
need to avoid physically or emotionally strenuous activities We
must also educate and make the patient understand about the
procedures that would be done to her. And notify the patient when
to call the physician to avoid further complications. Nurses must
not also forget to be empathetic in this situation. We can also
refer the patient to a counselling session or to just support her
free flow of emotional expression, this will help in the grieving
and healing process of the mother.

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 ST. PAUL UNIVERSITY DUMAGUETE
North National Highway, Bantayan Dumaguete City
College of Nursing
A.Y. 2021-2022

References
APA. (2021). Blood Transfusion During Pregnancy. Retrieved from American Pregnancy Association
Website: https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/blood-
transfusion-during-pregnancy/

HepB Foundation. (2021). Hepatitis B Blood Tests. Retrieved from Hepatitis B foundation Website:
https://www.hepb.org/prevention-and-diagnosis/diagnosis/hbv-blood-tests/

Marshall, S. (2020, October 08). Dilation and Evacuation (D&E). Retrieved from Mott Children's Hospital:
https://www.mottchildren.org/health-library/tw2462

Medication abortion. (2018, 05 16). Retrieved from Better health:

https://www.betterhealth.vic.gov.au/health/healthyliving/abortion-procedures-medication

Misoprostol for induction of labour after the late death of an unborn baby in the womb. (2013, April 30).
Retrieved from National Institute for Health and Care Excellence:
https://www.nice.org.uk/advice/esuom11/resources/misoprostol-for-induction-of-labour-after-
the-late-death-of-an-unborn-baby-in-the-womb-pdf-17427650245

Romito, K. (2021, February 11). Dilation and Evacuation (D&E). Retrieved from healthwise:
https://www.cham.org/HealthwiseArticle.aspx?id=tw2462

Weerakkody, Y. (2021, January 27). Umbilical arterial Doppler assessment. Retrieved from Radiopedia:
https://radiopaedia.org/articles/umbilical-arterial-doppler-assessment