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Nursing diagnosis:
PREMATURE LABOR
-Labor after fetal viability, but before fetal PRETERM RUPTURE OF MEMBRANES
maturity. Rupture of fetal membranes with loss of
-24th – 37th GA amniotic fluid before 37 weeks.
- Prognosis depends on birth weight and length Risk factors:
of gestation. Infection of membranes
Incompetent cervix
“The lower the birth weight the earlier the baby Trauma
is born, the lower is the chance for survival”
Complications: Infection, cord compression, Complication:
cord prolapse and preterm labor. - Fetal malpresentation
- Amniotic fluid embolism
Assessment: - PROM flowed by preterm labor
1. Slow steady trickle or a gush of fluid in - Infection
the vagina. - Prolapsed cord
2. The fluid is positive for nitrazine paper
test (blue)
3. Positive fernlike pattern on slide (due to Anaphylactic syndrome of pregnancy
estrogen) - The escape of AF containing debris (
meconium, lanugo, vernix caseosa) into
Nursing responsibility: maternal circulation
Assess for signs of labor. - Causing deposition of fluid/debris in the
If labor does not begin and fetus is still pulmonary arterioles.
young to survive. - Resulting to rapid respiratory distress,
o Bedrest shock, and possible development of
o Prophylactic antibiotics DIC.
o Fibrin based sealant
CAUSES: S/S
Nursing diagnosis. Oxytocin admin. Sudden sharp pan
Risk for infection Abruptio placenta Inability to breath
Anxiety Hydramnios Pale to cyanotic skin
Risk for injury
Management:
Implementation and collaborative care 1. Immediate oxygen inhalation
1. Assess FHR 2. CPR
2. Evaluate client’s temp every 2 hours 3. Baby should be delivered C/S (within 5
3. Avoid vaginal exams. minutes)
4. If woman survives the initial insult,
POLYHYDRAMNIOS/ HYDRAMNIOS there is increased risk of DIC.
Teratogen TOXOPLASMOSIS
Types Maternal effects:
1. Ingested agents Swollen lymph nodes
2. Maternal infection Flu-like symptoms
3. Environmental agents Fetal effects:
Severe malformations (skull & eyes)
Ingested agents: Active infection in the liver
MEDICATION Stillbirth
1. Dilantin – Cleft palate
2. Steroids – Cleft palate; abortion RUBELLA
3. Vitamin K – hemolysis; MATERNAL EFFECT: MILD RASH
hyperbilirubinemia FETAL EFFECTS:
4. Aspirin/ phenobarbital – bleeding DEAFNESS, MENTAL AND MOTOR
disorders CHALLENGES, CATARCTS AND CARDIAC DEFECTS
5. Streptomycin and quanine – 8th cranial
nerve damage CYTOMEGALOVIRUS
6. Iodine – Enlargement of fetal thyroid MOT: Droplet infection
gland, leading to tracheal compression Fetal effects:
7. Tetracycline – damage to developing 1. Neurologic symptoms
dental and osseous tissues (hydrocephaly/microcephaly) with
8. Chemotheraphy - major congenital deafness.
malformations esp. CNS 2. Chronic liver disease.
Contraindications:
a. previous classical/incision of uterus.
b. Large infant (>400g)
c. Malpresentation
d. Inadequate pelvimetry
Risks:
1. Possible uterine rupture and
haemorrhage.
2. Failure of trial of labor requires a repeat
C/S
Benefits:
1. Ability to experience labor and vaginal
delivery
2. Less costly
3. Faster, easier recovery period.
Nursing diagnosis:
Potential injury
Anxiety
Fear
Knowledge deficit.