Complications in
Pregnancy
Premature Labor
Labor occurring after 20 weeks
and before the 37 weeks of
gestation. Contraction is less than
10 minutes apart, leading to
progressive cervical changes and
cervical dilatation of 2cm or
effacement of 75%
Uterine contraction that
produces cervical changes Nursing Management
1. Assess the mother’s condition
Risk factors: and evaluate signs of labor.
Previous preterm labor Obtain a thorough
Abdominal surgery obstetric history.
Younger than 17-year-old Obtain specimens for
Low economic class complete blood count and
Abnormality of fetus or placenta urinalysis.
Multiple gestation Determine frequency,
Emotional and physical stress duration, and intensity of
Nutritional deficiency uterine contractions.
Determine cervical dilation
Focus: prevention of delivery of and effacement.
premature fetus Assess status of
Conditions to halt labor: membranes and bloody
Membranes are intact show.
Good FHB
No evidence of bleeding 2. Evaluate the fetus for distress,
Cervix not dilated more that 3-4 cm. size, and maturity (sonography
Effacement is no more than 50%. and lecithin-sphingomyelin ratio)
(If any of these conditions are not
present, delivery, regardless of fetal 3. Perform measures to manage or
age, is inevitable.) stop preterm labor.
Place the client on bed rest in
Conservative management refers to the side-lying position.
non-invasive or less aggressive Prepare for possible
treatments aimed at managing a ultrasonography,
condition without resorting to surgery or amniocentesis, tocolytic
more invasive procedures. The goal is often drug therapy, and steroid
to monitor the condition, alleviate therapy.
symptoms, and allow the body to heal or Administer tocolytic
recover naturally. (contraction-inhibiting)
Left lateral position and bedrest medications as prescribed.
Hydration which influenced halting Assess for side effects of
of contraction tocolytic therapy (e.g.,
decreased maternal blood
pressure, dyspnea, chest pain,
and FHR exceeding 180
beats/min).
4. Provide physical and emotional
support.
Provide adequate
hydration.
, 5. Provide client and family vagina in the absence of
education. contractions.
Pooling of amniotic fluid in the
vagina will be visualized
during a speculum
Premature Rupture of examination.
the Membranes (PROM) Maternal fever, fetal
tachycardia, and
Premature rupture of membranes
malodorous discharge may
(PROM) is a rupture (breaking
indicate infection.
open) of the membranes
(amniotic sac) before labor
2. Laboratory and diagnostic study
begins.
findings. Rupture of membranes is
If PROM occurs before 37 weeks
confirmed by the following.
of pregnancy, it is called preterm Ferning is evident.
premature rupture of Nitrazine test tape turns a
membranes (PPROM). PROM
blue-green color.
occurs in about 8 to 10 percent of
all pregnancies.
Etiology
The precise cause and specific Nursing Management
predisposing factors are unknown. 1. Prevent infection and other
potential complications.
Make an early and accurate
Pathophysiology
1. PROM is associated with evaluation of membrane
malpresentation, possible weak status, using sterile
areas in the amnion and chorion, speculum examination and
subclinical infection, and, determination of ferning.
possibly, incompetent cervix. Thereafter, keep vaginal
2. Basic and effective defense against examinations to a
the fetus contracting an infection is minimum to prevent
lost and the risk of ascending infection.
Obtain smear specimens
intrauterine infection, known as
Chorioamnionitis, is increased. from vagina and rectum as
3. The leading cause of death prescribed to test for beta
associated with PROM is infection. hemolytic streptococci, an
4. When the latent period (time organism that increases
between rupture of membranes and the risk to the fetus
Beta-hemolytic
onset of labor) is less than 24
hours, the risk of infection is low. streptococci are also
known as pyogenic
hemolytic
streptococci and have
Assessment Findings
the highest
1. Clinical manifestations
PROM pathogenicity. These are
is marked by
the causative agents of
amniotic fluid gushing from
various oral infectious
the vagina. The fluid may
diseases, including
merely trickle or leak from the
Pregnancy
Premature Labor
Labor occurring after 20 weeks
and before the 37 weeks of
gestation. Contraction is less than
10 minutes apart, leading to
progressive cervical changes and
cervical dilatation of 2cm or
effacement of 75%
Uterine contraction that
produces cervical changes Nursing Management
1. Assess the mother’s condition
Risk factors: and evaluate signs of labor.
Previous preterm labor Obtain a thorough
Abdominal surgery obstetric history.
Younger than 17-year-old Obtain specimens for
Low economic class complete blood count and
Abnormality of fetus or placenta urinalysis.
Multiple gestation Determine frequency,
Emotional and physical stress duration, and intensity of
Nutritional deficiency uterine contractions.
Determine cervical dilation
Focus: prevention of delivery of and effacement.
premature fetus Assess status of
Conditions to halt labor: membranes and bloody
Membranes are intact show.
Good FHB
No evidence of bleeding 2. Evaluate the fetus for distress,
Cervix not dilated more that 3-4 cm. size, and maturity (sonography
Effacement is no more than 50%. and lecithin-sphingomyelin ratio)
(If any of these conditions are not
present, delivery, regardless of fetal 3. Perform measures to manage or
age, is inevitable.) stop preterm labor.
Place the client on bed rest in
Conservative management refers to the side-lying position.
non-invasive or less aggressive Prepare for possible
treatments aimed at managing a ultrasonography,
condition without resorting to surgery or amniocentesis, tocolytic
more invasive procedures. The goal is often drug therapy, and steroid
to monitor the condition, alleviate therapy.
symptoms, and allow the body to heal or Administer tocolytic
recover naturally. (contraction-inhibiting)
Left lateral position and bedrest medications as prescribed.
Hydration which influenced halting Assess for side effects of
of contraction tocolytic therapy (e.g.,
decreased maternal blood
pressure, dyspnea, chest pain,
and FHR exceeding 180
beats/min).
4. Provide physical and emotional
support.
Provide adequate
hydration.
, 5. Provide client and family vagina in the absence of
education. contractions.
Pooling of amniotic fluid in the
vagina will be visualized
during a speculum
Premature Rupture of examination.
the Membranes (PROM) Maternal fever, fetal
tachycardia, and
Premature rupture of membranes
malodorous discharge may
(PROM) is a rupture (breaking
indicate infection.
open) of the membranes
(amniotic sac) before labor
2. Laboratory and diagnostic study
begins.
findings. Rupture of membranes is
If PROM occurs before 37 weeks
confirmed by the following.
of pregnancy, it is called preterm Ferning is evident.
premature rupture of Nitrazine test tape turns a
membranes (PPROM). PROM
blue-green color.
occurs in about 8 to 10 percent of
all pregnancies.
Etiology
The precise cause and specific Nursing Management
predisposing factors are unknown. 1. Prevent infection and other
potential complications.
Make an early and accurate
Pathophysiology
1. PROM is associated with evaluation of membrane
malpresentation, possible weak status, using sterile
areas in the amnion and chorion, speculum examination and
subclinical infection, and, determination of ferning.
possibly, incompetent cervix. Thereafter, keep vaginal
2. Basic and effective defense against examinations to a
the fetus contracting an infection is minimum to prevent
lost and the risk of ascending infection.
Obtain smear specimens
intrauterine infection, known as
Chorioamnionitis, is increased. from vagina and rectum as
3. The leading cause of death prescribed to test for beta
associated with PROM is infection. hemolytic streptococci, an
4. When the latent period (time organism that increases
between rupture of membranes and the risk to the fetus
Beta-hemolytic
onset of labor) is less than 24
hours, the risk of infection is low. streptococci are also
known as pyogenic
hemolytic
streptococci and have
Assessment Findings
the highest
1. Clinical manifestations
PROM pathogenicity. These are
is marked by
the causative agents of
amniotic fluid gushing from
various oral infectious
the vagina. The fluid may
diseases, including
merely trickle or leak from the
