A Reading on

PRETERM LABOR

In Partial Fulfillment of the

Requirements in NCM 209 – RLE

OB/GYNE ROTATION

Submitted to:

Rodeliza Faith Guillermo, RN, MN

Clinical Instructor

Submitted by:

Lyka Jhane M. Alilin, St. N

BSN 2F – Group 2

February 2, 2022
Title: Successful Treatment of Preterm Labor in Association with Acute COVID
19 Infection

Bibliography

Browne, P. C., Linfert, J. B., & Perez-Jorge, E. (2020). Successful treatment of

preterm labor in association with acute COVID-19 infection. American
journal of perinatology, 37(08), 866-868. Retrieved January 29, 2022 from
https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0040
1709993

Summary

Preterm labor is linked to a variety of acute viral infections, and vaccines

against these viruses have been shown to reduce the risk of preterm birth. COVID-
19 causes multiorgan infection, and recent cases show a preterm birth incidence
of up to 47%. As a result, infection during pregnancy raises the chance of preterm
labor.

The patient in this case had preterm labor due to an acute COVID-19
infection, but she was able to avert a low birth weight baby with standard treatment.
The patient is expecting a twin and suffers from asthma, which makes her more
susceptible to infection, and a migraine headaches. PRN albuterol inhaler and
fexofenadine were her current medications.

At 23 weeks of pregnancy, the client began to experience clinical symptoms

such as fever, cough, and myalgias. She was then tested for influenza,
streptococcal group A infection, and COVID-19. The first two tests came back
negative, and her COVID 19 result was still pending, therefore the patient was sent
home for a 14-day home quarantine. In the early stages of COVID infection, she
was given azithromycin, which appears to be helpful in reducing viral pneumonia.
For suspected bronchitis, a prednisone taper was prescribed, as well as
acetaminophen for fever.
 The patient returned to the emergency room nine days after seeing her OB,
complaining of uterine contractions and increasing vaginal discharge. The cervix
was closed on the initial examination, and a transvaginal ultrasound of the cervix
revealed funneling to the level of the exocervix. Her uterine contractions were
relieved by intravenous hydration and IV magnesium sulphate tocolysis, which she
discontinued on day three of her hospital stay. After discontinuing the medication,
the contractions stopped and the patient tolerated the usual preterm labor therapy
well. Her COVID 19 result came back positive 11 days after the sample was taken.

Standard preterm labor treatment appears to be successful during an acute

COVID-19 infection, according to the study. The delay in COVID-19 testing
findings supports current public health recommendations that all patients with
symptoms indicative of COVID-19 infections should be considered as presumptive
positive cases until their tests come back negative. As a result, unless maternal or
fetal decompensation occurs during therapy, acute COVID-19 infection should not
be a reason for an early elective birth.
Reaction

The article presented was timely due to the pandemic and that pregnant
women are considered susceptible to infections. Upon further researching for
similar articles, there are still limited studies regarding the relationship between
covid-19 and preterm labor. However, the paper presented that the covid-19
triggers preterm labor in exposed pregnant women.

The topic and article were interesting since there is an actual patient
assessment. Mothers’ are protective of their children and would like to overthink to
prevent any unfavorable circumstances that may harm the child, as also stated by
my mother. Through this report, pregnant women will be more at ease, especially
in this situation wherein no one is exempted from acquiring the virus if not careful.
Publishing this report is positive since it shows that we don’t need overwhelming
procedures to save the baby. Standard treatment for preterm labor can resolve the
presenting problems.

It was frustrating when the patient’s covid test result took 11 days to be
released. However, it brought relief when the initial drugs prescribed helped the
condition of the patient to have an acute infection knowing that she has
comorbidities that may increase her risk for critical condition. The client was also
commendable for subjecting herself to tests and check-up upon having symptoms.

Moreover, the information gathered in this article will be helpful to the

nursing education and profession, as we will be aware that regular treatment for
preterm labor helps to solve the presenting complications of pregnant women
exposed to the covid - 19. The lack of information for these current topics allows
the nursing professionals and educators to acquire new knowledge and think of
other interventions regarding this situation. This article aids the nursing practice
since nurses will be more alert on the treatment and possible complications for
infected pregnant women considering that the response of treatments and
interventions varies from person to person.
 Furthermore, the study also equips the nursing students to be
knowledgeable on the clinical manifestations of preterm labor and medications to
be prescribed as first-line treatment. This also boosts the students to do health
educations to the patients that covid-19 should not be an indication of early delivery
unless there is a fetal or maternal decompensation. Students will also be able to
encourage the mothers to have their vaccinations to reduce the risk of infection.

Additionally, research data is also beneficial for future researchers to

enhance the vaccines to be pregnant-friendly and reduce side or adverse effects
that may harm the fetus. It is also important to note the delay of test results may
increase the spread of the virus, especially if the safety protocol is not well followed
and there’s no proper monitoring for presumptive positive cases. With the report
presented, pharmaceuticals may develop medications to treat preterm labor
symptoms associated with virus infections.
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