Preterm Labor Causes and Assessment Quiz

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Questions and Answers

What is the main cause when the corpus luteum fails to produce enough progesterone during pregnancy?

Placental production of progesterone increases

Fetus fails to grow adequately (correct)

Increased estrogen production

Decreased prostaglandin release

Which infection can cross the placenta and affect the fetus during pregnancy?

Rubella (correct)

Chickenpox

Influenza

UTI

What is the term for the emergency condition caused by severe blood loss making the heart unable to pump enough blood to the body?

Corpus Luteum Shock

Hypovolemic Shock (correct)

Disseminated Intravascular Coagulation (DIC)

Rubella Shock

What is the term for the process that involves uterine contraction and cervical dilation leading to endometrial sloughing?

Dilation and Evacuation (D&E) Signup and view all the answers

What is the rule of thumb mentioned for assessing hemorrhage during miscarriage?

No more than one sanitary pad per hour is excessive Signup and view all the answers

What blood pressure measurement is defined as indicative of pre-eclampsia?

140/90 Signup and view all the answers

What is a common sign of pre-eclampsia affecting all organs?

Maternal fever Signup and view all the answers

What is the recommended treatment for preterm pregnancy less than 34 weeks in the presence of signs of infection?

Induce labor and administer antibiotics Signup and view all the answers

What is a potential indication of infection in pre-eclampsia?

Foul smelling vaginal discharge Signup and view all the answers

What action is recommended if pre-eclampsia is diagnosed in a term pregnancy?

Spontaneous labor and vaginal delivery Signup and view all the answers

What effect does excess production of thromboxane have on blood vessels during pregnancy?

Increases vasoconstriction Signup and view all the answers

How does gestational hypertension differ from normal pregnancy in terms of vascular responsiveness?

Blood vessels become less responsive to blood pressure changes Signup and view all the answers

What happens to the peripheral resistance during gestational hypertension?

It increases Signup and view all the answers

How does poor placental perfusion in gestational hypertension affect the fetus?

Reduces fetal nutrient and blood supply Signup and view all the answers

What is a consequence of ischemia in the pancreas during gestational hypertension?

Elevated amylase creatinine ratio Signup and view all the answers

What is the purpose of a McDonald cerclage?

To pull the cervix tightly together Signup and view all the answers

What does Placenta Previa refer to?

Placenta implants near or over the cervical os Signup and view all the answers

What is the postprocedure care following a cerclage?

Maintain the patient on bed rest as ordered Signup and view all the answers

What does Shirodkar's procedure involve?

Applying a submucosal band at the level of the internal cervical os Signup and view all the answers

What are some potential complications associated with 3rd trimester high-risk pregnancies?

Preterm Labor Signup and view all the answers

Which of the following is NOT a condition associated with premature labor?

Gestational diabetes Signup and view all the answers

What is a common symptom of preterm labor?

Pelvic pressure Signup and view all the answers

Which intervention aims to halt preterm labor?

Administering tocolytics Signup and view all the answers

What is one goal of interventions for preterm labor?

Maintaining bed rest and a lateral position Signup and view all the answers

Which of the following is associated with an increased risk of preterm labor?

Smoking Signup and view all the answers

What condition may warrant caution against analgesic agents during preterm labor?

>50% effaced cervix, 3-4 cm dilated Signup and view all the answers

Study Notes

Pre-Eclampsia

Defined as blood pressure higher than 140/90 measured on two separate occasions, more than 6 hours apart, without protein in the urine, and diagnosed after 20 weeks of gestation.
Affects all organs
Signs and symptoms:
- Sudden gush of clear fluid from the vagina
- Maternal fever
- Fetal tachycardia
- Foul smelling vaginal discharge (indicating infection)

Treatment of Pre-Eclampsia

In term pregnancy:
- Spontaneous labor and vaginal delivery
- Induction of labor
- Cesarean delivery
Preterm pregnancy (less than 34 weeks):
- Hospitalization and observation for signs of infection while waiting for fetal maturation
- Baseline cultures and sensitivity test if clinical status suggests infection
- Induce labor and IV administration of antibiotic if tests confirm infection

Causes of Pre-Eclampsia

Corpus luteum fails to produce enough progesterone
Infection: Rubella, syphilis, poliomyelitis, CMV, and Toxoplasmosis
UTI crosses the placenta, fetus fails to grow, and placental production of estrogen and progesterone fails

Complications of Miscarriage

Hemorrhage
- Assess amount of bleeding
- Rule of thumb: More than one sanitary pad per hour is excessive
- Monitor vital signs to detect hypovolemic shock
- Massage the uterine fundus to aid contraction
- Dilatation and curettage
- Suction curettage
- Transfusion

Cerclage

A procedure in which a suture or band is used to close the cervix using a vaginal approach
Types of cerclage:
- McDonald cerclage: sutures placed horizontally and vertically high up on the cervix to pull it tightly together
- Shirodkar's procedure: submucosal band applied at the level of the internal cervical os

Third Trimester Bleeding

Placenta Previa:
- Occurs when placenta implants near or over the cervical os rather than in the uterine fundus
- Causes bleeding
Premature Separation of the Placenta (Abruptio Placenta):
- Causes bleeding
Postprocedure Care:
- Maintain the patient on bed rest as ordered
- Assess for evidence of uterine contractions and rupture of membranes
- Monitor vital signs, especially temperature
- Assess for signs and symptoms of infection

Preterm Labor

Contraction characteristics:
- More frequent than every 10 minutes
- Last 30 seconds or longer
- Persistent (4 every 20 minutes)
Causes:
- Cervical incompetence
- Preeclampsia/eclampsia
- Maternal injury
- Infection (UTI and chorioamnionitis)
- Multiple births
- Placental disorders
Assessment:
- Uterine contractions (painful or painless)
- Abdominal cramping
- Low back pain
- Pelvic pressure or heaviness
- Change in the character and amount of usual discharge
- Rupture of amniotic membranes
Interventions:
- Goal: halt labor
- Focus on stopping the labor: identify and treat infection, restrict activity, and ensure hydration
- Maintain bed rest and a lateral position
- Monitor fetal status
- Administer fluids and medications as prescribed
- Tocolytics (nifedipine, indomethacin, magnesium sulfate, terbutaline sulfate)
- Labor that cannot be halted: membranes ruptured, cervix > 50% effaced, 3-4 cm dilated
- If very immature fetus: CS, NSD
- Caution against analgesic agents, epidural is preferred

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Description

Test your knowledge on the causes and assessment of preterm labor, including factors like cervical incompetence, infection, maternal injury, and placental disorders. Learn about the signs and symptoms associated with preterm labor.