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妇产科护理课件.ppt

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NursingCareforWomenwithPretermLabor,PrematureRuptureofMembranes,hekeyterms:pretermlabor,prematureruptureofmembranes,fetaldistressUnderstandthedifferenceinpertermbirthandlowbirthweightIdentifyrisksfactorsofpertermlaborUnderstandthecurrentinterventiontotreatpretermlaborDiscussthenursingcareforwomenexperiencedpertermlabor,pertermruptureofmembranes,andfetaldistressPertemLaborDefination:urringbetween20weeksan37weeksofpregnancyPertermbirthlead75%oftheperinatalmortalityPertermbirthalsoisthesecondleadingdeathofinfantsintheUSA,nexttoCHD.(ComerfordFreda,2000)PertermLaborandLowBirthWeightPertermLabor:<37weeksofgestationalageLowbirthweight::IUGRRiskFactorsofPretermLaborDemographicRisks:youngmother,lowsocioeconomicstatus,unmarried,lowlevelofeducationMedicalrisk:historyofpretermbirth,multipleabortions,uterineanomalies,lowpregnancyweight,DM,Hypertention,multiplegestation,infection,petentcervix,UTI,bleeding,placentapreviaorabruptioplancenta,anemia,fetalanomaliesBehavioralandEnvironmentalRiskforPretermLaborDiethylstilbestrol(DES)ExposureSmokingPoorNutritionAlcoholorothersubstanceuse,expeciallycocaineLateornoprenatalcareStress,uterineirritability,longworkinghours,inabillitytorestRiskFactorsforPertermLaborBacterialVaginosis40%increasedriskSyphilisandgonorrhea50%increasedriskAsymptomaticbacteriuria50%increasedriskSymptomsofPretermLabor20-37weeksofgestationalagePelvicpressurefeelslikethebabyispushingdownLow,dullbackacheMenstrual-likecrampsChangeorincreaseinvaginaldischargeUterinecontractions(hardness),every10minutesormoreoftenwithorwithoutpainIntestinalcrampingwithorwithoutdiarrheaSupressionofUterineActivityTocolyticsTherapy:Ritodrine(Yutopar)TerbutalineMagnesiumSulfateIndomethacinContraindicationstoTocolysisMaternalfactor:onditionthatcontraindicatescontinuationofpregnancy

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