Nursing care of Pregnant women who are risk for premature contraction : Two case studies

Abstract

     This study is a case study with the objectives of 1) study the nursing care of two pregnant women at risk of preterm delivery and 2) study and compare the differences in nursing care of two pregnant women at risk of preterm delivery.TwoSample is picked by select specific target group of pregnant women visited the prenatal care at the prenatal clinic, Chuen Chom Hospital, Mahasarakham Province, who have a positive urine pregnancy test and were being at risk of preterm delivery according to screening guidelines.
     The study found: Case study number1:22-year-old Thai woman G5P1A3L1,c Previous C/S, LMP 16 May 2022,EDC 22 February 2023.She had three previous miscarriages of unknown cause, BMI 25.21 kg/m².Physical examination, pregnancy examination, and laboratory tests were normal.She was identified as at risk for preterm delivery due to1) three or more consecutive miscarriages, 2) previous reproductive organ surgery (C/S), and 3) BMI > 23 kg/m².She was diagnosed with R/O Inevitable Abortion and sent to Mahasarakham Hospital to measureTVCL (Transvaginal cervical length) with normal result, the cervix is not short. She received Proluton 250 mg intramuscularly (IM) from 18⁺³weeks.to 29⁺³ weeks. of gestation, attended regular antenatal care visits, gained 30 kilograms during pregnancy, and delivered C/S GA 38+3 by U/S on 5 February 2023 at 7.25 a.m. The baby, a male, weighed 3,890 grams with Apgar scores of 9-10-10, and there were no complications for both the mother and the baby. Case study number 2:18-year-old Thai woman G1P0A0L0,LMP 14 February 2023,EDC 21 November 2023,first antenatal care GA 15⁺¹weeks. BMI 16.80 kg/m². She denied any medical illnesses but had a history of surgery for left ovarian cystectomy. Physical examination, pregnancy examination, and laboratory tests were normal.She was identified as at risk for preterm delivery due 1) previous reproductive organ surgery (left ovarian cystectomy), 2) BMI < 16.80 kg/m2, 3) primigravida, and 4) age less than 20 years old. She missed antenatal care appointments throughout her pregnancy, gained 6 kilograms by 34⁺² weeks of gestation, and presented with preterm labor symptoms 1 hour until arrived at hospital.On examination, her cervix was dilated 3 cm, with 75% effacement and -2 station, mucus and vaginal bleeding was found. She was initially managed at Chaing Chom Hospital and then referred to Mahasarakham Hospital due to fetal distress.She delivered via C/S on October 11, 2566, at 19:45, delivering a female baby weighing 1,800 grams with Apgar scores of 9-10-10. The baby hadgastroschisis andwas sent to Srinagarind Hospitalfor further treatment. Summary of diagnosis G1P0A0L0, GA 34⁺² weeks. by U/S Late ANC Teenage pregnancy Pre-term labor, C/S due to fetal distress.