Preterm Labour Nursing
Care Plan & Management
Description
▪ Preterm labour is labour that begins after 20 weeks’ gestation and
before 37 weeks’ gestation.
Aetiology
▪ Among the many causes of preterm labour are:
1. PROM
2. Preeclampsia
3. Hydramnios
4. Placenta previa
5. Abruptio placentae
6. Incompetent cervix
7. Trauma
8. Uterine structural anomalies
9. Multiple gestation
10. Intrauterine infection (chorioamnionitis)
11. Congenital adrenal hyperplasia
, 12. Fetal death
13. Maternal factors, such as stress (physical and emotional), urinary
tract infections, and dehydration.
Pathophysiology
▪ The uterus begins the process of contraction prior to term gestational
age.
Assessment Findings
▪ Clinical manifestations of preterm labour are basically the signs of true
labour that occur when the gestational age of the foetus is greater than
20 and less than 37 weeks.
1. Low back pain
2. Suprapubic pressure
3. Vaginal pressure
4. Rhythmic uterine contractions
5. Cervical dilation and effacement
6. Possible rupture of membranes
7. Expulsion of the cervical mucus plug
8. Bloody show
Nursing Management
1. Assess the mother’s condition and evaluate signs of labour.
▪ Obtain a thorough obstetric history.
▪ Obtain specimens for complete blood count and urinalysis.
▪ Determine frequency, duration, and intensity uterine contractions.
▪ Determine cervical dilation and effacement.
▪ Assess status of membranes and bloody show.
2. Evaluate the foetus for distress, size, and maturity (sonography and
lecithin-sphingomyelin ratio)
3. Perform measures to manage or stop preterm labour.
▪ Place the client on bed rest in the side-lying position.
▪ Prepare for possible ultrasonography, amniocentesis, tocolytic drug
therapy, and steroid therapy.
▪ Administer tocolytic (contraction-inhibiting) medications as prescribed.
▪ Assess for side effects of tocolytic therapy (e.g., decreased maternal
blood pressure, dyspnoea, chest pain, and FHR exceeding 180
beats/min).
4. Provide physical and emotional support. Provide adequate hydration.
Care Plan & Management
Description
▪ Preterm labour is labour that begins after 20 weeks’ gestation and
before 37 weeks’ gestation.
Aetiology
▪ Among the many causes of preterm labour are:
1. PROM
2. Preeclampsia
3. Hydramnios
4. Placenta previa
5. Abruptio placentae
6. Incompetent cervix
7. Trauma
8. Uterine structural anomalies
9. Multiple gestation
10. Intrauterine infection (chorioamnionitis)
11. Congenital adrenal hyperplasia
, 12. Fetal death
13. Maternal factors, such as stress (physical and emotional), urinary
tract infections, and dehydration.
Pathophysiology
▪ The uterus begins the process of contraction prior to term gestational
age.
Assessment Findings
▪ Clinical manifestations of preterm labour are basically the signs of true
labour that occur when the gestational age of the foetus is greater than
20 and less than 37 weeks.
1. Low back pain
2. Suprapubic pressure
3. Vaginal pressure
4. Rhythmic uterine contractions
5. Cervical dilation and effacement
6. Possible rupture of membranes
7. Expulsion of the cervical mucus plug
8. Bloody show
Nursing Management
1. Assess the mother’s condition and evaluate signs of labour.
▪ Obtain a thorough obstetric history.
▪ Obtain specimens for complete blood count and urinalysis.
▪ Determine frequency, duration, and intensity uterine contractions.
▪ Determine cervical dilation and effacement.
▪ Assess status of membranes and bloody show.
2. Evaluate the foetus for distress, size, and maturity (sonography and
lecithin-sphingomyelin ratio)
3. Perform measures to manage or stop preterm labour.
▪ Place the client on bed rest in the side-lying position.
▪ Prepare for possible ultrasonography, amniocentesis, tocolytic drug
therapy, and steroid therapy.
▪ Administer tocolytic (contraction-inhibiting) medications as prescribed.
▪ Assess for side effects of tocolytic therapy (e.g., decreased maternal
blood pressure, dyspnoea, chest pain, and FHR exceeding 180
beats/min).
4. Provide physical and emotional support. Provide adequate hydration.
