6.5 Preterm Flashcards
(49 cards)
Preterm (def)
Less than 37 weeks
Symptoms of Pre-term labor (6)
o Pelvic pressure
o Low, dull backache
o Menstrual-like cramps
o Change or increase in vaginal discharge
o Intestinal cramping with or without diarrhea.
o Ctxs occurring < or = q10 minutes
Risk factors for PTL (9)
o Infection o Long Distance Traveling o “On feet” > 50% o Stress: Acute or chronic o Poor nutrition, being underweight o Late or no prenatal care o Lower SES or education o ETOH, tobacco, illicit drug use o Pre-existing or pregnancy complications
Why is being on your feet a lot a risk factor for PTL?
Due to poor circulation, decreased venous return
Why is smoking a risk factor for PTL?
Vasoconstriction → decreased perfusion
What factors diagnose PTL?
• Documented _________
• Documented ________: (2)
1) Documented uterine contractions
2) Documented cervical change
• Effacement of 80%
• Dilation >1cm
What tool is used to detect PTL uterine contractions?
A tocometer
Biochemical markers to predict PTL
Best identify who will not experience PTL:
• Salivary estriol
• Fetal fibronectin (FFN)
Salivary Estriol: What does a negative test mean? How accurate is it?
A Negative test predicts the likelihood of not delivering in the next 2 weeks.
o 98% accurate that you will not go into preterm labor
Salivary Estriol: What does a positive test mean? How accurate is it?
A positive test predicts the likelihood of delivering in the next 2 weeks.
o Only right 7-25% of the time
Fetal Fibronectin: Its presence inthe birth canal between _____ weeks could indicate ____.
24-37 weeks
PTL
Fetal Fibronectin: What does a negative test mean? How accurate is it?
A negative test predicts the likelihood of not delivering in the net 2 weeks
o Correct 95% of the time
Fetal Fibronectin: What does a positive test mean? How accurate is it?
A positive test predicts the likelihood of delivering in the next 2 weeks.
o Only correct 25-40% of the time
Two tools that can help diagnose PTL
o Transvaginal ultrasound
o Home uterine activity monitoring (HUAM)
What is the purpose of tocolytic therapy?
Suppression of uterine activity
Five tocolytics
- Ritodrine
- Terbutaline
- Magnesium sulfate
- Indomethacin
- Nifedipine
Ritodrine: Class / Action
Betamimetic: Relaxes smooth mucscle
Terbutaline: Class / Action
Betamimetic: Relaxes smooth muscle
Terabutaline: Possible ADEs
- Cardiac (4)
- Muscles and CNS (3)
- GI and electrolyte (3)
- Respiratory
- Tachycardia
- Dysrhythmias
- Myocardial ischemia
- Hypotension
- Jitteriness, Apprehension
- Tremors / muscle weakness
- Headache
- N/V
- Hyperglycemia
- Hypokalemia
• Pulmonary edema
Magnesium Sulfate: Class/Action
CNS Depressant
Magnesium Sulfate: Antidote
Calcium Gluconate
What are normal blood levels for magnesium sulfate? How often are labs drawn?
Normal: 4-7 or 8
Labs drawn every 6 hours
Magnesium sulfate: ADEs (4)
- Decreased RR
- Absent or decreased deep tendon reflexes (DTRs)
- Muscle weakness
- Oliguria (decreased urine output).
Normal urine output:
- Per hour
- Per 24 hours
30 cc / hr
500 cc / 24 hour
