PRETERM LABOR

Preterm labor

- regular contractions of uterus resulting in

cervical changes that start before 37

weeks of pregnancy

- Cervical changes include effacement and

dilation

Preterm Birth

- birth that occurs between 20 weeks and

37 weeks of pregnancy

PREDISPOSING FACTORS

Unclear in Most instances but is associated with:

● Dehydration

● UTI

● Periodontal disease

● Chorioamnionitis

- infection of the fetal membranes

and amniotic fluid during pregna

● Intimate partner abuse

● Higher incidence in African American

Women

● Adolescents

● Women with inadequate prenatal care,

strenuous job during pregnancy, and

perform shift work (extreme fatigue)

SIGNS AND SYMPTOMS

● Persistent, dull, low backache

● Vaginal spotting

● Feeling of pelvic pressure or abdominal

tighten

● Menstrual-like cramping

● Increase vaginal discharge

● Uterine contractions

● Intestinal cramping

Maternal Complications

Anxiety

Fetal Complications

- Preterm infant

- Respiratory distress syndrome

- Hypoglycemia

- Intracranial hemorrhage

Hospital Admission

● Bedrest to relieve the pressure of fetus on

cervix

● IVF therapy to induce hydration which

activates the pituitary gland to secrete

antidiuretic hormone and oxytocin

Assess Overall Fetal Welfare

- Rule out infection: Vaginal and cervical

cultures

- Clean-catch urine sampling

- Give tocolytic agent to stop labor

(Terbutaline)

At Home Management

● Drink enough fluid

● Continue oral tocolytic agent

● Strict bed rest or limit strenuous activities

● Maintain adequate nutrition

● Do not smoke

Corticosteroids

● Give corticosteroid to hasten fetal lung

maturity

● Betamethasone - drug of choice

a. give if AOG is <34 weeks

b. 2 doses of 12 mg IM, 24 hours

apart

Tocolytic Agent

● Give tocolytic agent to stop labor

● Terbutaline - drug of choice, causes blood

vessels and bronchi to relax along with

uterine muscle