©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
PPN 301 Week 5: Labor at Risk, 4th Trimester
and Early Postpartum Exam Q&A 100% Pass
Preterm Labour - ✔✔cervical changes with uterine contraction occurring
between 20-37
Rate is higher among patients younger than 18 years of age or older than 35
years
Preterm Birth - ✔✔Any birth occurring before 37 weeks completion of
pregnancy regardless of the weight of the infant
Causes of Preterm Labour - ✔✔Infections
Vaginal bleeding
Hormone changes
Stretching of the uterus.
Signs and Symptoms of Preterm labour
,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Uterine Activity - ✔✔Uterine contractions more frequent than every 10 minutes,
persisting for 1 hour or more
Uterine contractions painful or painless
Signs and Symptoms of Preterm labour
Discomfort - ✔✔Lower abdominal cramping similar to gas pains; may be
accompanied by diarrhea
Dull, intermittent low back pain (below the waist)
Painful, menstrual-like cramps
Suprapubic pain or pressure
Pelvic pressure or heaviness; feeling that "baby is pushing down"
Urinary frequency
Signs and Symptoms of Preterm labour
Vaginal Discharge - ✔✔Change in character and amount of usual discharge:
thicker (mucoid) or thinner (watery), bloody, brown or colourless, increased
amount, odour
Predicting preterm labour and birth
,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Fetal fibronectin test (FFN)
Cervical length <30mm are risk preterm labour
Combination of both is better
Suppression of uterine activity
Tocolytics -used suppress labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate - ✔✔Tocolytics -used suppress
labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate
Early recognition and diagnosis is based on three major diagnostic criteria: -
✔✔1. Gestational age between 20 and 36 6/7 weeks
2. Regular uterine activity, accompanied by a cervical change
3. Initial presentation with regular contractions and cervical dilation of 2 cm or
greater
Contraindications of Tocolytics
Maternal - ✔✔Severe pre-eclampsia or severe gestational hypertension
Significant vaginal bleeding
, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Intrauterine infection (chorioamnionitis)
Cardiac disease
Medical or obstetrical condition that contraindicates continuation of pregnancy
Contraindications of Tocolytics
fetal - ✔✔Gestational age of 37 weeks or more
Fetal demise
Lethal fetal anomaly
Evidence of acute or chronic fetal compromise
Promotion of fetal lung maturity - ✔✔Antenatal glucocorticoids
to accelerate fetal lung maturity by stimulating fetal surfactant production.
Management of inevitable preterm birth - ✔✔magnesium sulphate may be
administered to reduce or prevent newborn neurological morbidity
Nursing Care for a Patient Receiving Tocolytic Therapy - ✔✔position patient in
lateral position to enhance placental perfusion and reduce pressure on the
cervix.
PPN 301 Week 5: Labor at Risk, 4th Trimester
and Early Postpartum Exam Q&A 100% Pass
Preterm Labour - ✔✔cervical changes with uterine contraction occurring
between 20-37
Rate is higher among patients younger than 18 years of age or older than 35
years
Preterm Birth - ✔✔Any birth occurring before 37 weeks completion of
pregnancy regardless of the weight of the infant
Causes of Preterm Labour - ✔✔Infections
Vaginal bleeding
Hormone changes
Stretching of the uterus.
Signs and Symptoms of Preterm labour
,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Uterine Activity - ✔✔Uterine contractions more frequent than every 10 minutes,
persisting for 1 hour or more
Uterine contractions painful or painless
Signs and Symptoms of Preterm labour
Discomfort - ✔✔Lower abdominal cramping similar to gas pains; may be
accompanied by diarrhea
Dull, intermittent low back pain (below the waist)
Painful, menstrual-like cramps
Suprapubic pain or pressure
Pelvic pressure or heaviness; feeling that "baby is pushing down"
Urinary frequency
Signs and Symptoms of Preterm labour
Vaginal Discharge - ✔✔Change in character and amount of usual discharge:
thicker (mucoid) or thinner (watery), bloody, brown or colourless, increased
amount, odour
Predicting preterm labour and birth
,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Fetal fibronectin test (FFN)
Cervical length <30mm are risk preterm labour
Combination of both is better
Suppression of uterine activity
Tocolytics -used suppress labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate - ✔✔Tocolytics -used suppress
labour -(no specific medication approved in Canada)
Nifedipine, indomethacin, magnesium sulphate
Early recognition and diagnosis is based on three major diagnostic criteria: -
✔✔1. Gestational age between 20 and 36 6/7 weeks
2. Regular uterine activity, accompanied by a cervical change
3. Initial presentation with regular contractions and cervical dilation of 2 cm or
greater
Contraindications of Tocolytics
Maternal - ✔✔Severe pre-eclampsia or severe gestational hypertension
Significant vaginal bleeding
, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.
Intrauterine infection (chorioamnionitis)
Cardiac disease
Medical or obstetrical condition that contraindicates continuation of pregnancy
Contraindications of Tocolytics
fetal - ✔✔Gestational age of 37 weeks or more
Fetal demise
Lethal fetal anomaly
Evidence of acute or chronic fetal compromise
Promotion of fetal lung maturity - ✔✔Antenatal glucocorticoids
to accelerate fetal lung maturity by stimulating fetal surfactant production.
Management of inevitable preterm birth - ✔✔magnesium sulphate may be
administered to reduce or prevent newborn neurological morbidity
Nursing Care for a Patient Receiving Tocolytic Therapy - ✔✔position patient in
lateral position to enhance placental perfusion and reduce pressure on the
cervix.
