VAGINAL PROGESTERONE IN WOMEN WITH AN ASYMPTOMATIC SONOGRAPHIC SHORT CERVIX IN THE MIDTRIMESTER DECREASES PRETERM DELIVERY AND NEONATAL MORBIDITY
SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENT FOR
NURS 5605- FAMILY HEALTH NURSING II
TEXAS WOMAN’S UNIVERSITY
SHEENA THOMAS, BSN, RN
TWU
COLLEGE OF NURSING HOUSTON, TX JULY 22, 2015
In maternal-child health in the United States and feasibly throughout the world, preterm birth is currently the most important problem and is the most significant challenge to modern obstetrics. According to the World Health Organization, a preterm birth is defined as birth before 37 completed weeks of gestation. The Centers for Disease Control and Prevention (2014) estimated that 1 in 9 infants born in United States are preterm babies. Preterm-related reasons of death together accounted for 35% of all infant deaths in 2010, more than any other single cause. Preterm birth is also a foremost cause of long-term neurological disabilities in children. Preterm birth costs the U.S. health care system more than $26 billion in 2005 (CDC, 2014). Preterm birth is a condition triggered by several etiologies, one of which is a drop in progesterone action, which makes cervical ripening. A sonographic short cervix (identified in the midtrimester) is a dominant forecaster of spontaneous preterm
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.
Giving birth to a baby is the most amazing and miraculous experiences for parents and their loved ones. Every woman’s birth story is different and full of joy. Furthermore, the process from the moment a woman knows that she’s pregnant to being in the delivering room is very critical to both her and the newborn baby. Prenatal care is extremely important and it can impact greatly the quality of life of the baby. In this paper, the topic of giving birth will be discussed thoroughly by describing the stories of two mothers who gave birth in different decades and see how their prenatal cares are different from each other with correlation of the advancement of modern medicine between four decades.
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.
Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).
Infant deaths in the neonatal period are caused by complications arising from preterm births, birth defects, maternal health conditions, complications of labor and delivery, and lack of access to appropriate care at the time of delivery. Infant deaths in the post-neonatal period are driven by sudden unexpected infant death (SUID) (including sudden infant death syndrome [SIDS]), injury, and infection (MMRW, 2013). An increasing proportion of post-neonatal infant deaths occur among infants who were born preterm but survived the neonatal period (Callaghan, 2006). On the other hand there is lesser knowledge of the incidence and etilogy of fetal mortality which according to MacDorman et al, makes fetal mortality an overlooked public health issue. Lee et al, echoed the same idea when they said infant mortality has been the main focus of public health programming while fetal deaths have gone untargeted. However, with the decrease in infant mortality rates there have been recent approaches such as perinatal period of risk analysis framework (PPOR) that highlight the need to include fetal
-Race or ethnicity: Historically, minority populations in the United States have had higher rates of preterm delivery. In 2007, non-Hispanic White women accounted for the lowest number of preterm births in the United States, accounting for only 11.5% of all preterm births (MacDorman, 2011). In contrast, non-Hispanic Blacks, Puerto Ricans, American Indians and Hispanic women had preterm birth levels of 18.3%, 14.5%, 13.9% and 12.3% respectively (MacDorman, 2011). The Asian minority had the lowest risk at 10.9% (MacDorman, 2011). Some studies have attributed such significant differences to racial disparities in resources and health care (Dominguez, 2008; Vanderbilt & Wright, 2013). However, other studies such as Menon’s et al, which looked at differences in White versus Black women, suggest that racial disparities in preterm birth may
The conclusion was ultimately reached that medical or elective induction of term women was associated with an increased risk of cesarean delivery and that estimate was determined heavily based on the Bishop Scores attained The study closes by advising that induction of labor, whether it is medical or electively induced, should be avoided because a low Bishop score means that the cervix is unripe and even with cervical ripening agents, the study showed that the risk of cesarean delivery for nulliparous women remained unchanged. Their advice is to allow the mothers to spontaneously go into labor if they have an unfavorable Bishop score because it will lower cesarean delivery rates (Vrouenraets et al. 2005). This rationale directly correlates
The significance that this mother did not receive prenatal care is that the risks for having a premature delivery could have been reduced or eliminated completely. The mother could have been put on medications to stop early labor like Magnesium sulfate to relax the smooth muscle of the uterus and stop contractions, progesterone to prevent early labor, and monitoring fetal heart rate patterns in order to report any complications to the attending provider caring for the patient. Progesterone reduces the risk of delivering a baby early, before 37 weeks gestation, in mothers who are pregnant with just a single fetus or a mother who previously had a premature birth of a fetus (Progesterone Treatment, 2014, para. 4). In
A concern that many women have who have undergone cesarean birth, is whether or not they can have a vaginal birth after. The answer is yes; they can have a vaginal birth, but only if the incision made was a horizontal one. The benefits are the woman ass’d with fewer blood transfusions, fewer post-partum infections and shorter hospital stays (Rose, 1). On the other hand there are many risks: the uterine may rupture, it could result in maternal and
Ricci, S. Kyle, T. and Carman, S. (2017). Maternity and pediatric nursing 3rd ed. Philadelphia:
Thank you for the opportunity to participate in the care of Ms. Megan Robertson, who as you know is a 20yo female, G2 P0101, currently at 16 weeks 5 days EGA with a pregnancy complicated by a history of prior spontaneous preterm delivery at 35 weeks of gestation and maternal underweight status. She presents today for evaluation of cervical length and fetal growth due to her history of prior preterm delivery and started her course of 17-alpha hydroxyprogesterone caproate injections today and these are weekly injections for her to reduce the risk of preterm birth secondary to her history of prior spontaneous birth.
Preterm birth can be a devastating experience not only for the mother, but also for the child. This issue has plagued the United States and other countries for many years, and no concrete evidence have been found to tell us why preterm birth occurs. One in eight babies in the United States is born premature each year. The impact of social support on the psychological well-being, attitudes, and behavior of parents is rapidly becoming a major issue. It is becoming more and more difficult for mothers to cope with the long-term and short-term effects of premature birth. These parents’ attitude and behavior can have both a direct and indirect effect on the child's
This was an observational cohort study among 19,151 women who gave birth vaginally in South Hospital in Stockholm, Sweden. It took place from April 2002 to December 2005, with the purpose of determining the role of birth positions and occurrence of severe perineal lacerations (Gottval, Allebeck, & Ekéus, 2007).
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
While some women who received no prenatal care had normal, uncomplicated births, others did not. Most of the women who did not receive adequate prenatal care gave birth to an underweight and underdeveloped infant. Among the benefits of early, comprehensive prenatal care are decreased risk of preterm deliveries and low birth weight (LBW)-both major predictors of infant morbidity and mortality. (Dixon, Cobb, Clarke, 2000). Preterm deliveries, deliveries prior to 37 weeks of gestation, have risen. Since the studies in 1987, which showed the rate of preterm deliveries as 6.9% of births, the 1997 rate shows an increase to 7.5%. Low birth weight, defined as an infant weighing less than 2500 grams (5lbs. 5oz) is often preceded by preterm delivery. Low