PREMATURE CERVICAL DILATATION

 Previously termed as incompetent cervix, refers to a cervix that dilates prematurely and therefore cannot
hold a fetus until term
 It occurs in about 1% of women and the dilatation is usually painless
 What causes incompetent cervix? Several conditions can cause incompetent cervix. They include:
o Abnormally formed uterus or cervix.
o Previous cervix surgery.
o Short cervix.
 Often the first symptom is showing a pink-stained vaginal discharge or increased pelvic pressure, which
may be followed by rupture of the membranes and discharge of the amniotic fluid
 Uterine contractions begin, and after a short labor the fetus is born.
 Usually diagnosed only after the pregnancy is lost

 Treatments for or approaches to managing an incompetent cervix might include:

o Progesterone supplementation.
o Cervical cerclage.
o Repeated ultrasounds.  

LABOR THAT CANNOT BE HALTED

 Preterm labor is too far advanced when they are first seen in a health care facility for it to be halted.

 If membranes have ruptured or the cervix is more than 50% effaced and more than 3 to 4 cm dilated, it is
unlikely labor can be halted

 There will be Rupturing of membrane

 If the fetus is very immature at the time labor cannot be halted, a cesarean birth may be planned

 Artificial rupture of the membranes is not done as a rule in preterm labor until the fetal head is firmly
engaged

 Larger episiotomy is done

 Following birth, the cord of the preterm infant is usually clamped immediately rather than waiting for
pulsations to stop. 

 Analgesic agents are administered with caution during preterm labor

 The immature infant will have enough difficulty breathing at birth without the additional burden of being
sedated from a drug such as meperidine (Demerol).

 If a woman wants pain relief, an epidural is preferable.