Nursing 209

N209: Reproductive Health Study Guide o o Risk factors include multiple gestation, reproductive abnormalities, such as shortened cervix, history of preterm labor, and age under 18 or over 35 o Medical conditions that increase risk: Urinary tract infections, STDs, vaginal infections, hypertension, IVF pregnancy, less than 6 months between pregnancies, placenta previa, and gestational diabetes o Race: African Americans are 50% more likely to have preterm labor o Environmental influences: Late or no prenatal care, tobacco use, alcohol, illegal drug use, domestic violence, and stress o Treatment includes progesterone, cerclage placement if cervical changes, and bedrest Prenatal vitamins should be initiated prior to conception if possible o Decreases risk for neural tube defects o Vitamin B can help with nausea and vomiting (often given in conjunction with Unisom) o Iron can be given for pregnancy-related anemia; may cause constipation (given Colace if it is severe) • Magnesium sulfate o Used with diagnosis of preeclampsia and preterm labor o FDA advises against use of MgS04 for more than 5-7 days for use in PTL, and has changed the drug class from Category A to D o ACOG continues to support the short-term use (less than 48 hours) for prevention of eclampsia, fetal neuroprotection before anticipated PTL of less than 32 weeks, and PTL for short term prolongation of pregnancy up to 48 hours to allow for administration of corticosteroids between 24-34 weeks if risk of delivery within seven days • Tocolytics o Inhibits myometrial (uterine) contractions o Used to prolong gestation by 2-7 days and provide time to transfer to NICU facility and administer corticosteroids o No clear first line drug for treatment of preterm labor o Drugs used include Magnesium Sulfate, Nifedipine, Terbutaline, and Indomethacin • Corticosteroids o Given between 24-34 weeks o Induces fetal surfactant production and reduces the risk for respiratory distress syndrome (or decreases severity) Occurs in 12% of all U.S. births 3.7 Pregnancy Medications • Vitamins o

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