Preterm or Premature Labor

Preterm or Premature  labor is a labor occurring after 20th week but before 37th. It may cause fetal death if delivered low birth weight but there's a good chance of survival if delivered 35th weeks onwards.

If labor occurs before 20 weeks of gestation, it is abortion; if beyond 37 weeks, it is a mature fetus.

Risk Factors of Preterm/Premature Labor

P - previous preterm labor
A - abdominal surgery
Y - younger than 17
O - older than 35
L - low socio-economic class
A - abnornality of fetus or placenta

M - multiple gestation
E - emotional and physical stress
N - nutritional deficiency

Focus: prevention of the delivery of premature fetus

Conditions to halt labor: membrane are intact, good FHT, no evidence of bleeding, cervix not dilated more than 3 - 4 cm, effacement not more than 50% (if any of these condition is not present, delivery, regardless of fetal age, is inevitable).


Maternal Complications requiring delivery of preterm infants are:

1. placental separation with uncontrolled hemorrhage
2. severe pre-eclampsia or eclampsia
3. uncontrolled renal or CVD
4. premature rupture of membrane
5. chorioamnionitis

Main Nursing Diagnosis: Fear

Nursing Implications

• bed rest in less stimulating environment at left lateral recumbent position
• adequate hydration
• use of steroids to prevent respiratory distress syndrome for infants
• prepare for delivery
• administer tocolytic agents (vasodilan, ritodrine, terbutaline, magnesium sulfate) as ordered, but prepare calcium gluconate as an antidote for MgSO4 toxicity.

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