3. Preterm Labor

what is preterm labor?

regular uterine contractions with cervical effacement and dilation from 20 weeks to before 37 weeks

why is preterm birth concerning?

the newborn’s organs may be immature, especially the lungs

what can increase the likelihood of preterm labor?

• previous preterm birth

• infections, including UTIs

• substance use

• multiple gestation

what symptoms can suggest preterm labor?

• menstrual-like cramps

• persistent low backache

• pelvic pressure

• increased or changed vaginal discharge

• spotting or leaking fluid

• frequent uterine tightening

what should a pregnant patient do about persistent low back pain that does not improve?

contact the provider for assessment

• preterm labor may occur without obvious abdominal pain

what contraction pattern warrants assessment for preterm labor?

4 contractions in 20 minutes or 8 contractions in 1 hour

what must accompany contractions to establish preterm labor?

cervical change

lab tests/diagnostics

• CBC

• urinalysis

• amniotic fluid analysis

what must be checked about the membranes when preterm labor is suspected? *

whether the membranes have ruptured (through fluid analysis)

what are tocolytic medications?

medications that suppress uterine contractions to temporarily delay birth

why is temporarily delaying preterm birth with tocolytics helpful?

it allows time for corticosteroids to improve fetal lung maturity

• it may also allow transfer to a facility with neonatal intensive care

what effect does magnesium sulfate have on uterine muscle?

it relaxes uterine smooth muscle and may reduce contractions

the nurse should monitor for _____ during magnesium sulfate administration?

toxicity

• deep tendon reflexes

• respiratory rate

• urine output

• level of consciousness

what should the nurse do if magnesium sulfate toxicity is suspected?

stop the infusion, notify the provider immediately, and support breathing as needed

what does betamethasone do before preterm birth?

it accelerates fetal lung maturity by increasing surfactant production

• it is a corticosteroid