- The Centers for Disease Control and Prevention recommends screening for Group B Streptococcus between weeks 35 and 37 of pregnancy (CDC, 2022).
- In the absence of GBS screening results, the patient would likely be treated presumptively with antibiotics to protect the premature baby from potential infection (Gibbs & Young, 2021).
- Other information that may be useful to ask includes the patient’s obstetric history, including any previous preterm births or other complications, as well as any current symptoms such as vaginal discharge or bleeding. Additionally, obtaining information on the patient’s social support and stress levels may be helpful, as these factors have been associated with an increased risk of preterm labor (Rosenberg et al., 2012).
- Nursing interventions may include monitoring fetal heart rate and uterine contractions, providing emotional support and education on preterm labor prevention measures, such as adequate hydration and rest, and assisting with obtaining any necessary medications or interventions ordered by the provider (Gibbs & Young, 2021).
- Screening tests that may be obtained to help determine the patient’s risk for preterm labor include cervical length measurement, fetal fibronectin testing, and assessment of bacterial vaginosis (Gibbs & Young, 2021).
- If the patient is determined to be in preterm labor, medications that may be used with a doctor’s order include tocolytics such as magnesium sulfate or terbutaline to delay delivery and corticosteroids such as betamethasone or dexamethasone to promote fetal lung maturity (Gibbs & Young, 2021).
- The dose, side effects, and possible results of these medications would be determined by the provider and would depend on the patient’s individual circumstances and medical history.
Centers for Disease Control and Prevention. (2022). Group B strept (GBS). Retrieved From https://www.cdc.gov/groupbstrep/index.html
Gibbs, R. S., & Young, P. C. (2021). Preterm labour and birth. In R. S. Gibbs, B. L. Karlan, A. F. Haney, & I. Nygaard (Eds.), Danforth’s obstetrics and gynecology (12th ed., pp. 254-277). Wolters Kluwer.
Rosenberg, T. J., Garbers, S., Chavkin, W., Chiasson, M. A., & Susser, M. (2012). Weight gain during pregnancy and adverse perinatal outcome in an ethnically-diverse population. Obstetrics, Gynecology and Reproductive Biology, 119(5) 976-982.
Other non-pharmacological methods of comfort that can be used by the patient are positioning such as lying on the side or standing up, using heat or cold, and relaxing techniques like breathing exercises. [ACOG], 2021).
Opioids such as fentanyl and morphine as well as local anesthesia like epidurals or spinal anesthesia could all be used as methods to control pain in labour (ACOG, 2021).
If there are no prenatal records, or a history of GBS (Group B Streptococcus), then the provider of healthcare would be required to administer antibiotic treatment prophylactically during labor in order to minimize the risk of infection of the neonate (ACOG 2021).
The use of nipple stimulating devices, ambulation or upright positions could be used to increase labor.