Premonitory Signs of Labor

1.    Lightening - presenting part of fetus descends to pelvic brim.
-    Results into resurgence of urinary frequency.
-    There is also increased in vaginal discharge and shooting pains down the leg to pressure in the sciatic nerve.

2.    Weight Loss - decreased 2-3 lbs. around 1-2 days before onset of labor due to decreased water retention as a result of decreased progesterone.

3.    Increased Activity Level
-    Increased secretion of adrenaline in preparation for much work ahead = labor.
-    Should be reserved for labor.

4.    Increased Braxton Hick’s Contraction
-    B-H is irregular painless practice contractions, which may appear even on 6th month.
-    It may reach an uncomfortable level.
-    May be confused with labor.
-    Will not dilate cervix but ripen it.

5.    Ripening of Cervix
-    Cervix becomes butter-soft and may dilate 1-2 cm.

6.    Rupture of Membranes - may be a gush or just a trickle.
a.    Patient should go to the hospital or physician.
b.    Test fluid with nitrazine paper to differentiate amniotic fluid from urine.
c.    Observe fluid for amount, color, odor, and meconium staining.
d.    Admit patient since birth is inevitable and may occur within 24 hours.
e.    If term, and labor does not start in 24 hours, induce labor.  If not at term, keep patient on bed-rest and give antibiotic therapy as a prophylaxis since disrupted integrity of uterus 2 degrees to ROM can predispose patient to infection.
f.    Complications include:
-  Cord prolapse - cord comes out before baby.
-    Cord compression.

7.    Backache due to fetal descent.

8.    Diarrhea as a result of increased nerve enervation due to descent.

9.    Bloody Show - 1st sign.
-    Pink-tinged mucus vaginal discharge.

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