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S 125 of all live births premature births account for

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Unformatted text preview: promote cervical ripening Preterm Birth Preterm Before 37 weeks gestation Leading cause of infant morbidity and Leading neonatal mortality neonatal U.S. – 12.5% of all live births Premature births account for 75% of all Premature neonatal mortality 50% of congenital neurologic deficits Most common neonatal respiratory Most distress syndrome distress Uterine Relaxants (Tocolytics) Uterine Used to delay delivery/preterm labor. – Prevent mom from delivering baby before 32 Prevent weeks weeks Average delay – only 48 hours. Average Suppress contraction of uterine smooth Suppress muscle. muscle. If used with glucocorticoids, the If glucocorticoids can accelerate fetal lung development. development. Also used to buy time to treat infection. Control of Myometrial Contraction Contraction Regulated by multiple mediators – Beta-adrenergic agonists – Oxytocin – Prostaglandins Classes of drugs----beta-adrenergic Classes antagonists, calcium channel blockers (cartiziem), cyclooxygenase (COX) inhibitors. Uterine Relaxants (Tocolytics) Uterine Beta2-selective adrenergic agonists – Terbutaline (Brethine) Beta2-selective adrenergic agonist Not approved by FDA for this use Decrease both the intensity and Decrease frequency of contractions by slowing down SNS down Uterine Relaxants (Tocolytics) Uterine Nifedipine (Procardia, Adalat, Nifedical) – Calcium channel blocker – Can suppress labor for up to 48 hours – Safer than ritodrine and just as effective Indomethacin (Indocin) – Cyclooxygenase inhibitor – Second-line tocolytic – High risk for neonatal complications – Prolonged renal insufficiency, Prolonged bronchopulmonary dysplasia, necrotizing enterocolitis, and periventricular leukomalacia enterocolitis, Uterine Relaxants (Tocolytics) Uterine Nursing Implications monitor vital signs and fetal heart tones Fetal heart tone: monitors babies heart rate Fetal monitor CBC- looking for infection monitor reassure mother review with patient limits to activity notify MD if labor begins again Uterine Stimulants (Oxytocics) Uterine Three groups of uterine stimulants: 1. Oxytocin (Pitocin)- speed things up 2. Ergot alkaloids 3. Prostaglandins Uterine Stimulants (Oxytocics) Uterine Oxytocin (Pitocin) – Hormone produced by the posterior pituitary – Increases the force, frequency, and duration of Increases uterine contractions uterine – Uterus becomes progressively more responsive Uterus to oxytocin throughout pregnancy to – Facilit...
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