早产、胎膜破裂、胎儿窘迫与女性护理母婴护理护理学12概要1.pptVIP

Nursing Care for Women with Preterm Labor, Premature Rupture of Membranes, and Fetal Distress 徐丽华 上海交通大学护理学院 Learning Objectives Define the key terms: preterm labor, premature rupture of membranes, fetal distress Understand the difference in perterm birth and low birth weight Identify risks factors of perterm labor Understand the current intervention to treat preterm labor Discuss the nursing care for women experienced perterm labor, perterm rupture of membranes, and fetal distress Pertem Labor Defination: Cervical change and uterine contractions occurring between 20 weeks an 37 weeks of pregnancy Perterm birth lead 75% of the perinatal mortality Perterm birth also is the second leading death of infants in the USA, next to CHD. (Comerford Freda, 2000) Perterm Labor and Low Birth Weight Perterm Labor: 37 weeks of gestational age Low birth weight: weight at time of birth is less than or equal to 2500 grams. Intrauterine growth retadation: IUGR Risk Factors of Preterm Labor Demographic Risks: young mother, low socioeconomic status, unmarried, low level of education Medical risk: history of preterm birth, multiple abortions, uterine anomalies, low pregnancy weight, DM, Hypertention，multiple gestation, infection, incompetent cervix, UTI, bleeding, placenta previa or abruptio plancenta, anemia, fetal anomalies Behavioral and Environmental Risk for Preterm Labor Diethylstilbestrol (DES) Exposure Smoking Poor Nutrition Alcohol or other substance use, expecially cocaine Late or no prenatal care Stress, uterine irritability, long working hours, inabillity to rest Risk Factors for Perterm Labor Bacterial Vaginosis 40 % increased risk Syphilis and gonorrhea 50% increased risk Asymptomatic bacteriuria 50% increased risk Symptoms of Preterm Labor20-37 weeks of gestational age Pelvic pressure feels like the baby is pushing down Low, dull backache Menstrual-like cramps Change or increase in vaginal discharge Uterine cont