Labor, premature

Complications Epididymitis and chronic prostatitis (uncommon) Male infertility (decreased sperm motility and viability) Pelvic inflammatory disease and associated complications (i.e., ectopic pregnancy, infertility) Premature labor, premature rupture of membranes, and low-birth-weight infants (risk of neonatal infections is low) Cervical neoplasia... 

Develop a nursing care plan for Ms. Morris, a 28-year-old, woman who is admitted to the obstetric unit with premature labor during her third trimester. This is her second child, and die has had two miscarriages. She is prescribed ritodrine for preterm labor. Analyze what nursing diagnoses would have the highest priority. Discuss how you would explore and plan to meet her emotional needs. 

Mothers of preterm infants were also more likely than mothers of full-term infants to have obstetrical complications at the time of delivery. Eighty percent of mothers of preterm infants had three or more obstetrical complications. Possible complications included premature labor, oremature rupture of membranes, prolonged rupture of membranes, Caesarean section, chorioamnionitis, and marginal placenta abruption. In contrast, only one mother of a full-term infant developed obstetrical complications during the perinatal period. 

It is not a first-line agent owing to lower efficacy compared with oral metronidazole in non-pregnant populations.38 Avoid clindamycin vaginal cream due to associations with premature labor and neonatal infection.38... 

The lower birth weight of infants of mothers who consume 300 mg or more of caffeine per day is due entirely to retarded fetal growth. There is no evidence that premature labor and delivery are associated with caffeine during pregnancy. 

Bacterial vaginosis is a risk factor for premature rupture of membranes, preterm labor, preterm birth, spontaneous abortion, and postpartum endometritis. 

Calcium Channel Blockers. The calcium channel blockers work by blocking the influx of calcium, an excitatory ion, into the cell. The first calcium channel blocker, verapamil (Calan), was introduced in the 1960s. Others, including diltiazem, nifedipine, and nimodipine, are now available. The calcium channel blockers have been used to treat a variety of medical conditions including high blood pressure, cardiac pain (angina) and arrhythmias, migraines, seizure disorders, and premature labor. 

Tocolysis. The uterine relaxant effect of P2-adrenoceptor agonists, such as terbutaline or fenoterol, can be used to prevent premature labor. Vasodilation Ltillmann, Color Atlas of Pharmacology (... 

Labor - Use with caution in women delivering premature infants. 

Labor and delivery - May produce fetal bradycardia, respiratory depression, apnea, cyanosis, and hypotonia in the neonate. Maternal administration of naloxone during labor has normalized these effects in some cases. Use with caution in women delivering premature infants. 

Up to 15% of premature infants and even some babies delivered by cesarean section have inadequate levels of surfactant, producing respiratory distress syndrome, which is characterized by cyanosis and symptoms of labored breathing. 

The indications are bronchial asthma, cardiogenic or septic shock, cardiac arrest and premature labor. 

In addition to its use as a bronchodilator, terbutaline is used extensively to control premature labor, since contractions of uterine smooth muscle are abolished by adrenomimetics (see Chapter 62). 

The limiting side effect associated with orally administered Pz-adrenoceptor agonists is muscle tremor, which results from a direct stimulation of Pz-adreno-ceptors in skeletal muscle. This effect is most notable on the initiation of therapy and gradually improves on continued use. 2-Agonists also cause tachycardia and palpitations in some patients. When used by intravenous infusion for premature labor, P2-agonists have been re-... 

Intravenous use of ethanol, while once widely employed to inhibit premature labor, is now of historical interest only. Ethanol inhibits oxytocin release from the pituitary and thus indirectly decreases myometrial contractility. Today, pz-adrenomimetics and magnesium sulfate have replaced ethanol for parenteral tocolysis. 

Terbutaline (Brethine, Bricanyl) is a relatively specific P2-adrenoceptor agonist (see Chapters 10 and 39). Terbutaline can prevent premature labor, especially in individuals who are more than 20 weeks into gestation and have no indication of ruptured fetal membranes or in whom labor is not far advanced. Its effectiveness in premature labor after 33 weeks of gestation is much less clear. Terbutaline can decrease the frequency, intensity, and duration of uterine contractions through its ability to directly stimulate Pj-adrenoceptors. While it appears to be especially selective for P2-receptor activation, terbutaUne does have some Pi activity as well. 

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