1
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- Spontaneous rupture and leakage of amniotic fluid prior to the onset of
labor
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2
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- Preterm PROM
- Occurs before 37th week
- 1-2% of pregnancies
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3
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- Maternal
- Risk of infection is that of C/S
- Fetal
- Respiratory distress
- Sepsis
- Malpresentation
- Prolapse
- Increased perinatal morbidity and mortality
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4
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- Risk of infection increases with time
- Assess length of time membranes ruptured
- Observe for signs of infection
- Fever
- Increased pulse
- CBC
- Character of amniotic fluid
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5
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- Rest on left side
- Hydration
- Bedrest
- No vag exams unless absolutely necessary
- Fetal monitoring
- Explain therapy and implications of PROM
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6
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- Promotes fetal lung development
- Induces pulmonary maturation and decreases incidence of fetal distress
- Stimulates biosynthesis of surfactant
- Increases size of aveoli
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7
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- Maternal
- Hyperglycemia
- Risk for infection (not well supported)
- Fetal
- Low cortisol levels
- Hypoglycemia
- Sepsis (neonatal)
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8
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- Risk for infection r/t PROM
- Impaired gas exchange in fetus r/t umbilical cord compression
- Risk for ineffective coping r/t unknown outcome of pregnancy
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9
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- Labor that occurs between 20-37 weeks is preterm
- #1 prenatal and neonatal problem in the United States
|
10
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- Placenta Previa
- Abruptio Placenta
- Hydramnios
- 2nd trimester bleeding
- Fetal anomaly/death
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11
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- Genital tract infections
- Incompetent cervix
- Uterine malformation
- Fibroids
- Limited PNC
- Low pre-pregnancy weight
- Smoking/drugs
- Occupation/work
- Sexual activity
- Anemia
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12
|
|
13
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- Hx of PTL
- Race
- DES exposure
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14
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- Prevent the preterm birth of a compromised infant
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15
|
|
16
|
|
17
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- Use of medications to try to stop labor
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18
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- Client may feel warm of flushed
- Nasal congestion
- Lethargy
- Sluggishness
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19
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- Fear r/t risk of early labor
- Ineffective coping r/t need for constant attention to pregnancy
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20
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- Describe dangers of PTL
- Recognition of early labor sx
- Lay down 2-3x/d
- Empty bladder q2h
- Pelvic rest
- Focus on 1 day at a time
- If on BR get up and get dressed everyday
- Distracting activities
- Teach to palpate contractions
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