Pbl Preterm Delivery and Rds

Topics: Childbirth, Cervix, Acute respiratory distress syndrome Pages: 9 (1776 words) Published: February 28, 2013

Name of the Faculty: Vimala Edwin Date: 15-01-2013 Group Leader: Jayanthi
Scriber: Joncy Kutty Samuel
Group 3 Roll No: From (31-40)
Group Members:
1. 12090531 Elizabeth Thomas
2. 12090532 Susan
3. 12090533 Joncy kutty Samuel
4. 12090534 Amble
5. 12090535 Amina
6. 12090536 Jayanthi
7. 12090537 Laila
8. 12090538 Rabeea
9. 12090539 Mini Varghese
10. 12090540 Nora

Group Norms:

1. Place cell phones on silent.
2. Speak confidentially.
3. Team spirit.
4. Maintain confidentiality.
5. Speak up; don’t keep it to yourself if it contributes to our development. 6. Speak honestly and with consideration and respect of others and their efforts. 7. Active participation.

Elizabeth Thomas reads the scenario.

* Abdominal pain.
* 2-3 mild to moderate contractions in 10 minutes.
* Leaking per vagina since yesterday, 36 hours.
* Cervix opened 5cm.
* 60% effaced.
* Strong contraction.
* Apgar score low.
* Grunting and flaring is present.
* Low birth weight
* Tachypnea
* Tachycardia.
* Respiratory distress syndrome.
Learning Objectives:
1. Define the preterm delivery.
2. Identify the causes of preterm delivery.
3. List the signs and symptoms.
4. Mention the Investigations and Diagnostic test.
5. Explain the Medical and Nursing Management.
6. Elaborate Emergency management of the preterm baby.
7. Define Respiratory Distress Syndrome(RDS).
8. Identify the Causes of RDS.
9. Discuss common findings in RDS.
10. List appropriate Initial diagnostic test for preterm newborn and compare newborn with RDS. 11. Enumerate medical Management of preterm baby.
12. Formulate nursing care plan for infant with RDS.
13. Discuss the prognosis of the baby.

1. Define the preterm delivery?
Preterm labor is the presence of contractions of sufficient strength and frequency to effect progressive effacement and dilation of the cervix between 20 and 37 weeks' gestation

2. Identify the causes of preterm delivery?
* Placental abruption
* Uterine over distension
* Cervical incompetence
* Infections (chorioamnionitis), associated infections BV, ureaplasma, mycoplasma, peptostreptococcus, and bacteroides . * Ruptured membranes
* Placenta previa
* Placental abruptions
* Diabetes
* Connective tissue disorders
* Pyelonephritis

3. List the signs and symptoms?
* Contractions (your belly tightens like a fist) every 10 minutes or more often * Change in vaginal discharge (leaking fluid or bleeding from your vagina) * Pelvic pressure—the feeling that your baby is pushing down * Low, dull backache

* Cramps that feel like your period
* Belly cramps with or without diarrhea
* None
* Pelvic pressure
* Increasing discharge
* Contractions (painless or painful)
* Intestinal cramping, with or without diarrhea
* Back ache
* Menstrual cramps
Urgent Symptoms:
If any of the following symptoms occur, call your health care provider immediately: * Fluid leaking from the vagina
* Vaginal bleeding
* Odorous vaginal discharge
* Contractions every 5 minutes or less

4. Mention the investigation and diagnostic test?
* History (Prior PTL, membrane status, discharge, fevers, number or size of fetus, associated medical problems) * Tocodynamometer and FHR monitoring
* Physical exam- fundal height and tenderness
* Labs-CBC, UA +/- culture, electrolytes
* Sterile speculum exam obtaining cultures for group B strep, BV, GC, Chlamydia, obtain fetal fibronectin * Cervical length measurement...
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