Forwards

Preterm delivery happens during 20^th ~ 36^th gestational week. There is no obvious sign and the chance is 5 ~ 10 %.

Etiology

1. 70 % ~ 80 % of the preterm delivery is unknown.
2. Cervical insufficiency.
3. Patients suffering from heart disease, retinopathy, diabetes, and preeclampsia.
4. Traumas like a punch on the abdomen or accidental fall.
5. Placenta previa or abruptio.
6. Severe maternal diseases like infection.
7. Uterine abnormality.
8. Multiple pregnancy, polyhydramnios.
9. Premature rupture of membranes.
10. History of preterm delivery.

Clinical symptoms

1. When there are 4 uterine contractions every 20 minutes or 6 contractions every hour; and more than 2 centimeters of dilated cervical or more than 80 % effaced cervical, it is the sign of preterm delivery and tocolysis. If there is increased frequency of uterine contraction, it is “premature uterine contraction”.
2. Lower back pain or backache.
3. Abdominal convulsion.
4. Compression to the pelvis.( feeling fetus pushing downward )
5. Increased or odor-changed vaginal discharge.

Treatment

A. Tocolysis agents

1. To reduce the chance of preterm labor from happening, doctors often prescribe intravenous tocolysis medicine to ease and sooth uterus muscle.
2. Do not panic if there are side effects of the tocolysis medications because they do not affect the baby: tachycardia, nausea, vomiting, constipation, palpitation, hyperglycemia, electrolyte imbalance, occasional pulmonary edema, and etc. Notify our medical staff for oxygen or take a rest or lie down when there are aforementioned side-effects.
3. Doctors would prescribe intravenous antibiotics to reduce potential infection from happening.
4. To reduce the incidence of newborn respiratory distress, doctors will inject steroid to accelerate fetus’ pulmonary maturity.

B. bed rest

The nursing measures

1. Complete bed rest, either lie down on the bed or reclining on the bed.
2. Do not move heavy objects to avoid over-exciting exercises because they could induce uterine contraction.
3. Be aware of the symptoms of infection like elevated body temperature.
4. If there is regulated uterine contraction, vaginal watery gushing, or increased vaginal bleeding, inform our medical staff immediately.
5. Uterine contraction could be induced by constipation, eat fiber-rich food like fruit to prevent the problem.
6. Return to the hospital for scheduled prenatal exam.