SPECIAL SITUATIONS IN LABOR AND DELIVERY
Accurate assessment of the rapid changing status of the mother and her fetus is
essential if the nursing and the medical care plan are to meet their needs. Although
most labors and deliveries are routine, occasionally there may be a deviation from the
norm. This lesson contains information that will help you in caring for a patient who has
a special situation in labor and delivery. The special situations in labor and delivery are
categorized as preterm labor, postterm labor, induction of labor, dystocia of labor,
oversized babies, amniotic fluid embolism, multiple pregnancies, cesarean section,
episiotomies, and forceps delivery.
PRETERM LABOR AND DELIVERY
Preterm birth is traumatic for both the parent and the child. The parents are
faced with an unexpected emotional crisis as a result of the natural process of
pregnancy and birth being altered, whereas, the infant is faced with adjustment to
extrauterine existence before final readiness for the event. Parents and the infant who
are experiencing the crisis of premature birth need the concerted support of all
members of the health care team.
a. Definition. Preterm labor is labor that occurs prior to 38 weeks gestation. It
may be spontaneous or medically induced.
b. Conditions That Predispose to Preterm Labor. There are certain factors
or reasons that may increase a woman's chances of having premature labor, but the
specific cause or causes of premature labor are not known. Sometimes a woman may
have premature labor for no apparent reason. Nevertheless, it is important that you be
familiar with the following conditions of a patient who may predispose to preterm labor:
Spontaneous rupture of membranes.
Cervical incompetency - weakness of the cervix.
Overdistended uterus caused by hydramnios or two or more fetuses.
Anomalies of the products of conception.
Faulty placentation - abruptio placentae, placenta previa.