PREMATURE

Cervical
DILATATION
reviously termed as

Incompetent
Cervix
 Incompetent
Cervix
-inability of the cervix to hold the
fetus any longer until term because it
has dilated prematurely.
 RISKfactors
o Previous history of unexplained pre-mature labor pains or
miscarriage
o Cervical surgery (e.g trachelectomy)
o Chemical exposure (e.g Diethylstilbestrol)
 RISKfactors
o Short cervix
o born with a connective tissue disorder (such as
hypermobility or ehlers danlos syndrome)
o Increased maternal age
 Signs and Symptoms
•Show or “the bloody show”
•Increased pelvic pressure
•Premature rupture of membranes
•Period type pains in your abdomen or lower back.
Diagnostic Test
•transvaginal scans
•Vaginal swabs
 Surgical
Management
•McDonald’s Cervical
Cerclage
- Nylon sutures are placed horizontally and vertically
across the cervix.

•Shirodkar Cervical
 Nursing
Management
 Nursing Assessment
• Ask the woman who is reporting for
painless bleeding if she is feeling an intense
pressure on her pelvis.
• Inspect and save pads used by the woman
during bleeding to determine any clots or tissues
that already passed out.
• Determine if the woman is experiencing true
contractions to prepare for the birth of the fetus.
Nursing Diagnosis
Anxiety related to impending loss of
pregnancy as evidenced
by premature dilation of
the cervix.
 Nursing
Interventions
•Determine any factors that further
contribute to the anxiety of the woman so
it could be avoided.
•Monitor vital signs to determine any physical
responses of the patient that could affect
her condition.
 Nursing
Interventions
•Convey empathy and establish a therapeutic
relationship to encourage client to express
her feelings.
•Provide accurate information about the
situation to help client back into reality.
•Evaluation
 Evaluation
•Patient would appear relaxed and report
that anxiety has been reduced.
•Verbalize awareness of feelings of anxiety.
•Enumerate ways to deal with anxiety.
•Use resources or support system effectively.