Pre Term Premature Rupture Of Membranes ( Pprom ) Essay

G4 P3003 (4 Gestations, 3 Full Term, 0 Preterm, 0 Miscarriages, 3 Currently Living); 3 Spontaneous Vaginal Deliveries; Last birth was 7 years ago by SVD, weighed 4000 grams; No previous obstetrical complications or morbidity; No past medical history; No past surgical history; No prior antenatal care

According to the World Health Organization (WHO, 2016), preterm birth are the birth that happened before 37 ended weeks of pregnancy and is one of the number reason of newborn deaths and the second prominent cause of deaths in children below five. The preterm babies have chances of an amplified risk of illness, disability and death. In the first weeks, the complications of premature birth may include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, metabolism problems, immune system problems. Long-term complications includes cerebral palsy, impaired cognitive skills, vision problem, hearing problems, dental problems, behavioral and psychological problems, chronic health issues.

On November 23, 1993, Doe was seen by an obstetrician, Dr. James Meserow, at the St. Joseph’s Hospital in Chicago. This was the first time Doe was seen by Dr. Meserow, but she had been receiving regular prenatal care throughout her pregnancy. Upon giving Doe the usual check-up, he determined from a series of tests that the baby was under duress due to an issue with the placenta. At this point, it is important to recognize that Doe is a mentally competent woman carrying her first child, and the fetus is currently around 35 weeks. It also important to recognize that Dr. Meserow is a board-certified obstetrician/gynecologist. Dr. Meserow informs both Doe and her husband of the diagnosis and highly recommends either an immediate cesarean section or to induce labor in order to prevent any further potential damage to the fetus due to the lack of oxygen from the compromised placenta. Doe refuses both of the recommendations based on her religious convictions that God will heal her child and keep it safe from any harm, and will, therefore, wait to have a natural childbirth.

Defining premature birth is much more than just a denotative phrase. It is not just a preterm birth, or a baby born early. It is a life-changing event, and something that affects millions of people worldwide. The intense quiet room with heart monitors beeping, as parents see their baby and are devastated. Loved ones can not feed them or kiss them nor, can they not hold them or hug them. They do not get the same experience as others. Little miracles lay inside these cubes where multiple wires are help keeping them alive. A place where prayers happen, and where all hope for the best. Nobody knows the true pain and struggle behind a preterm birth and it needs to be discussed. Prematurity is a serious conflict; therefore, it needs more awareness as many families are facing this tough situation.

A premature birth is a birth that takes place more than three weeks before the baby is due. A normal pregnancy usually lasts about 40 weeks. The importance of growth and development of the baby happens through pregnancy. Premature birth gives the baby less time to develop in the mother’s womb. A late preterm is when a baby is born between 34-36 weeks of pregnancy. Moderately preterm are born between 32-34 weeks. Very preterm is born less than 32 weeks of pregnancy and extremely preterm is born before 25 weeks. “Each year nearly 500,000 babies are premature or preemies. That is about 1 out of every 8 infants born in the U.S.”

During our initial assessment of Ms. K.R., the following vital signs were noted: blood pressure was 147/67, temp 36.6 degrees Celsius, pulse 80 beats per min., respiratory rate of 20, pulse ox 99% on room air, a pain score of 8 during contractions, and fetal heart tones had a baseline of 130 over the last two hours. Her labs showed 2+ protein in her urine but she denied any headaches, vision changes, right upper quadrant pain, and no DTRs or colonus were observed. Ms.K.R. seemed to be handling her labor well, with the exception of being in a lot of pain and unable to find a comfortable position.

Because her initial pregnancy was preterm based on PPROM, she would be a candidate for 17-OHP and this was discussed and would recommend that this start at around 16-18 weeks gestation. In addition, because of her prior history of cesarean deliveries as well as her HIV status the plan will be to undergo a repeat cesarean in this pregnancy at around 38 weeks gestation and she does have good dates. She does have a follow-up appointment in your office in 3-4 weeks.

Keia is a 31yo, G2 P0100, who is currently 9 weeks 6 days as dated by a 6-week scan that was off from her LMP. She has a history of an IUFD at 29 weeks. She reports that she had decreased fetal movement prior to coming in and there being no fetal heart tones on examination, but other than that there were no other significant precipitating events. She did have an increased risk for Down syndrome at 1:140 but per the old reports all of her analytes were within normal limits. At the time of delivery, the baby did appear to be appropriate weight and there were no obvious causes at the time of delivery. She reports that she had chromosomes performed after and the chromosomes were negative. She also thinks she had a full autopsy that was unremarkable. She did have a work-up for clotting disorders due to the history of loss and according to the chart everything is relatively within normal limits except for MTHFR which was heterozygous for C677T and A1298C. I did not see beta-2 glycoprotein or antithrombin III. Because of the relatively normal work-up she is on a baby aspirin and Metanx. She is here today to discuss her history and plans for this pregnancy.

The intention of this family paper was to visit and assess R.M., C.M., and their two sons, J.M. and G.M., and provide them with information to better their health or function as a family. An in home assessment was performed on R.M. and his family to evaluate the objective and subjective needs of the family. R.M., the husband, is 31 years old and is married to C.M., also 31 years old. They are a traditional nuclear family with two sons, J.M., 5 years old, and G.M., 2 years old. C.M. is currently 35 weeks pregnant (upon fourth home visit) with the couple’s first female child. C.M. has had two previous Caesarean sections, the first being an emergency

It is our pleasure to see and perform FTS on Ms. Kaylyn Houser. She is a 16yo, G1 P0, with EDD by LMP consistent with an 8-week 4-day ultrasound performed in your office. The patient has a history of anxiety and what sounds like bipolar disorder, narcolepsy, and sleep apnea, as well as prepregnancy BMI of 32. She was previously on Lamictal, Luvox, and magnesium when she started the pregnancy and comes today attempting to wean from the Lamictal currently taking 100 mg daily. Her surgical history is notable for ankle surgeries. She has no prior pregnancy history. Her social history is negative x3. Her registration BP is 137/81. Her urine dip is negative for protein.

This particular case study involves a 29 year old obstetric patient who presented to the labor and delivery unit at 33 weeks gestation with complaints of abdominal pain for the past three days that had become more severe and absence of fetal movement noted since the previous evening. Her obstetric history revealed she has one living child and has had one previous miscarriage at ten weeks

When the patient was dilated to a three, the doctor ruptured her amniotic sac and they contacted the anesthesiologist to get an epidural and catheter placed. As the day continued, the nurse kept increasing her Pitocin to help her progress. She was unable to eat or drink and was only able to chew on ice chips. She had monitors on her abdomen to allow the nurse to watch her contractions and baby’s heart rate. The patient also had to get blood pressures taken every fifteen minutes since she had preeclampsia. The hospital’s priority was to monitor the baby and mother closely to make sure the mother and the baby remained healthy. Another priority of the agency was to get the baby out in a timely manner. The agency I was at used prostaglandins and oxytocin to assist with this process, which helped to augment and induce contractions to progress labor. The other patient I encountered was also being induced, and she was at 39 weeks. After three doses of Cytotec with no change, the nurse continued to give it, even though the patient’s body was not ready to

Preeclampsia is a condition that occurs only during pregnancy. Some symptoms of preeclampsia may include high blood pressure and protein in the urine, occurring after week 20 of pregnancy. Preeclampsia is often precluded by gestational hypertension. While high blood pressure during pregnancy does not necessarily indicate preeclampsia, it may be a sign of another problem. Preeclampsia affects at least 3-5% of pregnancies. If undiagnosed, preeclampsia can lead to eclampsia, a serious condition that can put pregnant women and their baby at risk, and in rare cases, cause death. Women with preeclampsia who have seizures are considered to have eclampsia. The exact causes of preeclampsia and eclampsia a result of a placenta that doesn't function properly

Pregnancy is normally the best and the happiest stage of any woman, but it can also be uncertain because anything can go wrong if you do not know exactly what to do. In order to understand the reasons of why Preterm Birth occurs, it is important to know what it is and how risky it can be. Preterm Birth is also known as Premature labor which mainly begins after “20 weeks but before 37 completed week’s gestations. Approximately 12.9 million babies worldwide are born too early every year representing an incidence of PTB of 9.6%” (Berghella, pp. 2, 8). Baby Center Medical Advisory Board says that about 12 percent of babies

The sign and symptoms of PPH include; the apparent excessive bleeding, hematocrit-reduction of the number of red blood cells, reduced blood pressure, development of symptoms of shock and anaemia, and severe pain and swelling of tissues and muscles of the vagina, vulva, pelvic and perineum (Simpson & Creehan, 2008). Besides, Ricci & Kyle (2009) avow that there are different factors that place a mother at risk for PPH, and they comprise; prolonged first, second or third stage of labour, previous history of PPH, foetal macrosomia, uterine infection, arrest of descent and multiple gestation. Other risk factors may include; mediolateral episiotomy, coagulation abnormalities, maternal hypertension, maternal exhaustion, malnutrition or anaemia, preeclampsia, precipitous birth, polyhydramnios and previous placenta previa (Ricci & Kyle, 2009).