COLLEGE OF ALLIED HEALTH SCIENCES

School of Nursing

CASE STUDY

SIGNIFICANCE OF THE CASE STUDY

PATIENT PROFILE

I. BIOGRAPHIC DATA

II. CHIEF COMPLAINTS

III. HISTORY OF THE PRESENT ILLNESS

IV. PAST MEDICAL HISTORY

V. VITAL SIGNS

VI. REVIEW OF ANATOMY & PHYSIOLOGY OF REPRODUCTIVE SYSTEM

VII. MEDICAL DIAGNOSIS

ETIOLOGIC FACTORS

Predisposing Factors Precipitating Factors

Modifiable Non-Modifiable Modifiable Non-Modifiable

CLINICAL MANIFESTATIONS

Subjective Data Objective Data

 PATHOPHYSIOLOGY

LABORATORY AND DIAGNOSTIC TESTS

MEDICAL MANAGEMENT

DRUG STUDY

CARE PLANS

APPLICATION OF NX THEORIES

REFERENCES
SIGNIFICANCE OF THE CASE STUDY

Preterm labor (PTL) is a critical obstetric emergency affecting 10-15% of pregnancies worldwide and is the
leading cause of neonatal morbidity and mortality. Early recognition and intervention can prevent preterm birth
and improve neonatal outcomes. This case study demonstrates the assessment, management, and nursing
care required for a patient experiencing preterm labor at 32 weeks gestation.

PATIENT PROFILE

I. BIOGRAPHIC DATA

Name: J.P.P.
Age: 30 years old
Sex: Female
Civil Status: Married
Religion: Roman Catholic
Occupation: Office clerk
Address: Iloilo City, Philippines
Date of Admission: December 8, 2025
Time of Admission: 2:30 PM
Chief Complaint: Lower abdominal cramping and contractions

II. CHIEF COMPLAINTS

"I've been having painful stomach cramps that come and go every 10 minutes since this morning."

III. HISTORY OF THE PRESENT ILLNESS

J.P.P. is a G2P1 (1-0-0-1) at 32 weeks and 3 days age of gestation (AOG) by last menstrual period (LMP). She
reports experiencing lower abdominal cramping that started around 8:00 AM today, initially dismissed as
Braxton Hicks contractions. The contractions became progressively more regular, occurring every 10-15
minutes, lasting 30-40 seconds each, with increasing intensity. She also noticed increased vaginal discharge
but denies vaginal bleeding or rupture of membranes. She reports feeling the baby move normally. Patient
came to the emergency room at 2:30 PM when contractions became uncomfortable and more frequent.
IV. PAST MEDICAL HISTORY

Obstetric History:

• G2P1 (1-0-0-1)
• Previous delivery: Normal spontaneous vaginal delivery (NSVD) 3 years ago, full-term, healthy male
infant weighing 3 kg
• Current pregnancy: Regular prenatal check-ups, no complications noted until today

Medical History:

• Urinary tract infection (UTI) treated 2 weeks ago with antibiotics (completed course)
• No history of hypertension, diabetes, or thyroid disorders

Surgical History: None

Family History: Mother has history of preterm delivery

Personal/Social History:

• Works 8-10 hours daily as office clerk with minimal breaks

• Denies smoking or alcohol use
• Lives with husband and one child
• Reports high stress levels due to work demands

V. VITAL SIGNS

Blood Pressure: 115/75 mmHg

Heart Rate: 88 bpm
Respiratory Rate: 20 bpm
Temperature: 37.1°C
Oxygen Saturation: 98% on room air
Pain Scale: 6/10 during contractions

Fetal Heart Rate: 145 bpm, regular, reactive

Uterine Contractions: Every 8-10 minutes, lasting 35-40 seconds, moderate intensity

VI. REVIEW OF ANATOMY & PHYSIOLOGY OF REPRODUCTIVE SYSTEM

The Uterus During Pregnancy:

The uterus is a hollow, muscular organ consisting of three layers:

 1. Endometrium (inner lining) - becomes decidua during pregnancy
2. Myometrium (middle muscular layer) - responsible for contractions
3. Perimetrium (outer serous layer)

Normal Labor Physiology:

Labor normally occurs at 37-42 weeks gestation when:

• The fetus reaches maturity

• Hormonal changes trigger uterine contractions (increased oxytocin receptors, prostaglandin production,
decreased progesterone)
• The cervix undergoes ripening, effacement (thinning), and dilation

Uterine Contractions:

Normal Braxton Hicks contractions are irregular, infrequent, and non-progressive. True labor contractions are:

• Regular and rhythmic

• Increasing in frequency, duration, and intensity
• Accompanied by cervical changes (effacement and dilation)

The Cervix:

A closed, thick cervix (>3 cm long) maintains pregnancy. During labor:

• Effacement: Cervix thins from 100% (3 cm) to 0% (paper-thin)

• Dilation: Cervical opening expands from 0 to 10 cm

Preterm Labor Context:

When labor begins before 37 weeks, it threatens fetal maturity. At 32 weeks, the fetus has developing
lungs (surfactant production beginning) but remains at risk for respiratory distress syndrome, intraventricular
hemorrhage, and other complications of prematurity.

VII. MEDICAL DIAGNOSIS

Preterm Labor at 32 weeks and 3 days Age of Gestation (AOG)

Definition: Regular uterine contractions occurring before 37 weeks of gestation accompanied by cervical
changes (effacement and/or dilation).

Diagnostic Criteria:

• Gestational age between 20-37 weeks

• Regular uterine contractions (≥4 in 20 minutes or ≥8 in 60 minutes)
 • Cervical dilation ≥2 cm or effacement ≥80%
• Progressive cervical change on examination

Patient's Status:

• 32 weeks 3 days AOG

• Contractions every 8-10 minutes
• Cervical examination: 2 cm dilated, 60% effaced, -2 station
• Intact membranes

ETIOLOGIC FACTORS

Predisposing Factors Precipitating Factors

Modifiable Non-Modifiable Modifiable Non-Modifiable

1. Multiple gestation
1. Recent urinary tract 1. Prolonged
1. Previous preterm risk - Though this
infection (UTI) - Bacterial standing/physical stress at
delivery (family history) - patient has singleton
infection can trigger work - Working 8-10 hours
Mother's history suggests pregnancy, multifetal
inflammatory cascade and with minimal breaks
genetic predisposition gestation is non-
prostaglandin release increases uterine irritability
modifiable if present

2. High occupational
2. Maternal age and 2. Inadequate rest and 2. Current gestational
stress - Chronic stress
parity - Being G2P1 with hydration - Dehydration and age (32 weeks) -
elevates cortisol and
inter-pregnancy interval fatigue can trigger uterine Cannot modify current
catecholamines, triggering
affects uterine readiness contractions pregnancy timeline
contractions

3. Inadequate prenatal 3. Race/ethnicity and

3. Fetal factors - Fetal
care education - genetic factors - Certain 3. Untreated/recent
maturity, placental
Insufficient knowledge populations have higher infection - Recent UTI may
aging, and hormonal
about warning signs PTL risk; genetic have incompletely resolved,
triggers are beyond
delayed medical predisposition from causing inflammation
maternal control
consultation maternal history
CLINICAL MANIFESTATIONS

Subjective Data Objective Data

"I've been having painful stomach Vital Signs: BP 115/75 mmHg, HR 88 bpm, RR 20 bpm, Temp
cramps since this morning" 37.1°C

"The cramps come and go every 10 Uterine contractions: Regular, every 8-10 minutes, lasting 35-40
minutes" seconds, moderate intensity on palpation

Cervical examination: 2 cm dilated, 60% effaced, vertex at -2

"I noticed more vaginal discharge today"
station

"The pain is about 6 out of 10 when it

Fetal heart rate: 145 bpm, regular, reactive with accelerations
happens"

Reports increased pelvic pressure Increased vaginal discharge noted (clear, mucoid)

Denies vaginal bleeding or fluid leakage Membranes intact on sterile speculum examination

Reports normal fetal movements Patient appears anxious, grimacing during contractions

Expresses anxiety about baby coming Abdomen gravid, fundal height 30 cm, appropriate for gestational
too early age

PATHOPHYSIOLOGY

Normal Pregnancy Maintenance (Before 37 weeks)

TRIGGERING FACTORS

• Infection/Inflammation (UTI → cytokine release)

• Maternal stress (↑ cortisol, catecholamines)
• Physical strain (prolonged standing, inadequate rest)
• Genetic predisposition (family history)

DISRUPTION OF PREGNANCY MAINTENANCE

Inflammatory Cascade Activation

 • Bacterial products or stress hormones trigger inflammatory mediators
• Release of interleukins (IL-1, IL-6, IL-8) and tumor necrosis factor-α (TNF-α)

Prostaglandin Production ↑

• Inflammatory cytokines stimulate prostaglandin synthesis

• Prostaglandins (PGE2, PGF2α) promote myometrial contractility

Hormonal Changes

• Progesterone effect decreased (local withdrawal)

• Oxytocin receptor expression increased in myometrium
• Corticotropin-releasing hormone (CRH) levels rise

CERVICAL CHANGES

• Matrix metalloproteinases (MMPs) activated

• Cervical collagen breakdown
• Cervical ripening → effacement and dilation

MYOMETRIAL ACTIVATION

• Gap junction formation between smooth muscle cells

• Increased myometrial sensitivity to contractile stimuli
• Enhanced calcium influx into myometrial cells

COORDINATED UTERINE CONTRACTIONS

• Regular, rhythmic contractions begin

• Frequency and intensity increase progressively
• Contractions propagate from fundus to lower segment

PROGRESSIVE LABOR

• Continued cervical dilation and effacement

• Descent of presenting part
• If untreated → preterm birth
↓

MANIFESTATIONS:

• Subjective: Lower abdominal cramping, pelvic pressure, increased discharge, back pain
• Objective: Regular contractions (≥4 in 20 min), cervical changes (dilation ≥2 cm, effacement ≥50%),
increased vaginal discharge

POTENTIAL COMPLICATIONS:

• Maternal: Anxiety, side effects from tocolytic medications, increased risk for cesarean delivery
• Fetal/Neonatal: Respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis,
sepsis, long-term neurodevelopmental issues, neonatal death

LABORATORY AND DIAGNOSTIC TESTS

Test Result Normal Values Interpretation

Complete Blood Count

(CBC)

11-14 g/dL Normal; mild physiologic

- Hemoglobin 11.8 g/dL
(pregnancy) anemia of pregnancy

- Hematocrit 35% 33-44% (pregnancy) Normal

6,000-16,000/μL Normal; slight elevation

- WBC 11,500/μL
(pregnancy) acceptable in pregnancy

Urinalysis

- Color Pale yellow Pale to dark yellow Normal

Normal (post-treatment for

- WBC 3-5/HPF 0-5/HPF
recent UTI)

- Bacteria Negative Negative No active infection

No growth Confirms resolution of recent

Urine Culture No growth
after 48 hours UTI

Negative (<50
Indicates increased risk of
Fetal Fibronectin (fFN) Positive ng/mL) after 22
delivery within 7-14 days
weeks

>30 mm at this Short cervix indicates high risk

18 mm
gestational age for preterm delivery
Transvaginal
Ultrasound - Cervical
Length

Obstetric Ultrasound

Consistent
- Fetal biometry Appropriate for GA Normal fetal growth
with 32 weeks

- Amniotic fluid index 12 cm 8-18 cm Normal amniotic fluid volume

Fundal, anterior, or
- Placental location Fundal Normal placental position
posterior

1,700-2,000 g at 32
- Estimated fetal weight 1,850 grams Appropriate for gestational age
weeks

Reactive (≥2
Non-Stress Test (NST) Reactive accelerations in 20 Reassuring fetal well-being
min)

Group B Result pending (typically done

Streptococcus (GBS) Pending Negative at 35-37 weeks; done early due
Screening to PTL)

MEDICAL MANAGEMENT

1. Admission and Monitoring

• Admit to labor and delivery unit for continuous monitoring

• Continuous electronic fetal monitoring (EFM)
• Frequent vital signs assessment
• Intake and output monitoring

2. Tocolytic Therapy (To inhibit contractions)

• Nifedipine (Adalat) 20 mg PO loading dose, then 10-20 mg PO every 4-6 hours

o Calcium channel blocker, first-line tocolytic
o Monitor blood pressure
• Alternative: Indomethacin 50-100 mg rectal suppository, then 25-50 mg PO every 6 hours (if <32
weeks)

3. Corticosteroid Therapy (For fetal lung maturation)

• Betamethasone 12 mg IM every 24 hours x 2 doses

 o Accelerates fetal lung maturity
o Reduces risk of respiratory distress syndrome, intraventricular hemorrhage
o Maximum benefit achieved between 24 hours to 7 days after administration

4. Magnesium Sulfate (For neuroprotection)

• Loading dose: 4-6 grams IV over 20-30 minutes

• Maintenance: 1-2 grams/hour IV infusion
• Monitor deep tendon reflexes, respiratory rate, urine output
• Used for neuroprotection in imminent preterm birth <32 weeks

5. Antibiotic Therapy

• Group B Streptococcus (GBS) prophylaxis: Penicillin G 5 million units IV loading dose, then 2.5-3
million units IV every 4 hours until delivery (if GBS status unknown or positive)

6. Hydration

• IV fluids: Lactated Ringer's solution or Normal Saline at 125-150 mL/hour

• Dehydration can contribute to uterine irritability

7. Bed Rest

• Modified bed rest with bathroom privileges

• Left lateral position to optimize uteroplacental perfusion

8. Patient Education

• Warning signs of preterm labor progression

• Importance of medication compliance
• Activity restrictions
• When to return to hospital

9. Continuous Assessment

• Serial cervical examinations (every 2-4 hours initially)

• Monitor for rupture of membranes
• Assess for vaginal bleeding
• Monitor for medication side effects

DRUG STUDY

Drug #1: NIFEDIPINE (Adalat)

Classification: Calcium channel blocker, Tocolytic agent

Mechanism of Action: Nifedipine blocks calcium influx through voltage-dependent L-type calcium channels in
myometrial smooth muscle cells. By preventing calcium entry, it inhibits the calcium-calmodulin complex
formation necessary for myosin light chain kinase activation, thereby preventing smooth muscle contraction
and inhibiting uterine contractions.

Indication: Tocolysis in preterm labor (off-label use)

Dosage:

• Loading dose: 20 mg PO (immediate release)

• Maintenance: 10-20 mg PO every 4-6 hours as needed
• Maximum: 180 mg/day

Route: Oral (PO)

Contraindications:

• Hypersensitivity to nifedipine or other calcium channel blockers

• Hypotension (SBP <90 mmHg)
• Concurrent use with magnesium sulfate (relative contraindication - risk of severe hypotension and
neuromuscular blockade)
• Intrauterine infection
• Preeclampsia with severe features
• Maternal cardiac disease

Side Effects:

• Common: Headache, flushing, dizziness, nausea, palpitations

• Cardiovascular: Hypotension, tachycardia, peripheral edema
• Other: Constipation, fatigue

Adverse Reactions:

• Severe hypotension
• Maternal pulmonary edema (especially with concurrent IV fluid administration)
• Hepatotoxicity (rare)

Nursing Responsibilities:

Before Administration:

• Obtain baseline vital signs, especially blood pressure and heart rate
• Assess uterine contraction pattern and cervical dilation
• Review contraindications and current medications
• Ensure IV access is established
• Explain purpose and potential side effects to patient

During Administration:
 • Monitor blood pressure every 15-30 minutes after loading dose, then every hour during maintenance
• Maintain blood pressure >90/60 mmHg
• Monitor heart rate (expect mild increase)
• Assess for headache, flushing, dizziness
• Position patient in left lateral position to prevent supine hypotension

After Administration:

• Continue monitoring vital signs every 2-4 hours

• Assess contraction frequency, duration, and intensity
• Monitor for signs of hypotension (dizziness, lightheadedness, syncope)
• Evaluate effectiveness: decrease in contraction frequency and intensity
• Monitor fetal heart rate continuously
• Assess for adverse effects: severe headache, chest pain, shortness of breath
• Educate patient to report dizziness, severe headache, or palpitations immediately
• Encourage adequate hydration but monitor fluid balance
• Document contraction pattern, vital signs, and patient response

Drug #2: BETAMETHASONE (Celestone)

Classification: Corticosteroid, Glucocorticoid

Mechanism of Action: Betamethasone is a synthetic glucocorticoid that crosses the placenta and stimulates
fetal lung maturation. It accelerates the production of surfactant by type II pneumocytes in fetal lungs,
promoting alveolar stability and reducing surface tension. It also induces structural maturation of the lungs,
enhances fluid clearance, and upregulates beta-adrenergic receptors. Additionally, it reduces the risk of
intraventricular hemorrhage and necrotizing enterocolitis in preterm neonates.

Indication: Acceleration of fetal lung maturity in women at risk of preterm delivery between 24-34 weeks
gestation

Dosage:

• 12 mg IM every 24 hours for 2 doses (total of 2 injections)

• May repeat course once if delivery has not occurred and patient remains at risk after 7 days (per
physician order)

Route: Intramuscular (IM)

Contraindications:

• Known hypersensitivity to betamethasone

• Active maternal infection (relative - weigh risk vs benefit)
• Chorioamnionitis (relative contraindication)
• Pulmonary tuberculosis (active, untreated)

Side Effects:
 • Maternal: Hyperglycemia, fluid retention, insomnia, mood changes, injection site pain
• Fetal: Transient decrease in fetal heart rate variability and movements (24-48 hours post-
administration)

Adverse Reactions:

• Maternal pulmonary edema (when combined with tocolytics and IV fluids)

• Infection risk with multiple courses
• Hyperglycemia (especially in diabetic patients)
• Adrenal suppression with repeated courses

Nursing Responsibilities:

Before Administration:

• Verify gestational age (24-34 weeks)

• Confirm indication for corticosteroid administration
• Check for contraindications and allergies
• Assess baseline vital signs and blood glucose
• Review maternal history for diabetes or gestational diabetes
• Explain purpose, benefits, and potential side effects to patient
• Inform patient about temporary decrease in fetal movements (normal for 24-48 hours)

During Administration:

• Use proper IM injection technique (ventrogluteal or vastus lateralis muscle preferred)

• Administer deep IM injection
• Rotate injection sites if multiple doses given
• Document injection site, time, and dose

After Administration:

• Monitor blood glucose levels, especially in diabetic patients (check 2 hours post-injection, then as
ordered)
• Assess for signs of hyperglycemia: polyuria, polydipsia, elevated blood glucose
• Monitor vital signs every 4 hours
• Continue fetal heart rate monitoring
• Reassure patient if fetal movements decrease temporarily (typically returns to normal within 48-72
hours)
• Monitor for signs of infection: fever, uterine tenderness, foul vaginal discharge
• Assess for fluid retention and signs of pulmonary edema if patient receiving IV fluids and tocolytics
• Document maternal response and any adverse effects
• Educate patient:
o Maximum benefit occurs 24 hours to 7 days after completion of course
o Importance of completing both doses
o Report signs of infection, difficulty breathing, or excessive swelling
o Blood glucose monitoring if diabetic
• Ensure second dose is scheduled and administered 24 hours after first dose
• Communicate with neonatal team about antenatal corticosteroid administration
NURSING CARE PLAN

Nursing Diagnosis #1: Risk for Preterm Birth related to preterm labor at 32 weeks gestation as
evidenced by regular uterine contractions and cervical changes

Assessment Diagnosis Planning Intervention Rationale Evaluation

Goal: Independent: Independent:

*Pregnanc
1. Monitor and 1. Establishes
y will be document
prolonged baseline and detects After 8 hours:
contraction changes in labor
Subjective: to at least frequency, pattern *Contractions
34 weeks
"I've been duration, and decreased to every
gestation 2. Lateral position
having intensity every 15-20 minutes,
or delivery improves
painful hour lasting 20-25
will be uteroplacental blood
stomach seconds
delayed 2. Maintain patient flow and reduces
cramps
every 10 Risk for for at least
in left lateral uterine irritability *Cervical
minutes" Preterm 48 hours position examination
Birth to allow 3. Dehydration can unchanged: 2 cm
3. Encourage trigger uterine
Objective: related to corticoster dilated, 60% effaced
adequate fluid contractions
preterm oid
* 32 weeks 3 administra intake (oral or IV * Patient received
labor at
days AOG as ordered) 4. Activity increases both doses of
tion.
32 weeks uterine irritability betamethasone
*Contraction 4. Promote bed
gestation Outcome
s every 8-10 rest with bathroom 5. Stress increases * Fetal heart rate
as s:
minutes, privileges only catecholamine remains reactive
evidenced
lasting 35-40 *After 8 release which can
by regular 5. Minimize stimulate contractions * Patient verbalizes
seconds hours of
uterine stressful stimuli; understanding of
nursing
*Cervix 2 cm contractio interventio provide calm 6. Detects early signs condition and
dilated, 60% ns and environment of complications treatment
ns, patient
effaced cervical
will 6. Monitor vital 7. Early detection
changes
*Positive signs every 2-4 allows prompt
1. Goal partially met.
fetal hours intervention
Demonstr Continue
fibronectin
ate 7. Assess for signs 8. Ensures fetal well- interventions and
*Cervical decreased of labor being monitoring.
length 18 contractio progression:
mm n increased Re-evaluate in 24
frequency contractions, Dependent: hours.
(<4 per rupture of
hour) membranes, 1. Tocolytics inhibit
vaginal bleeding uterine contractions
Assessment Diagnosis Planning Intervention Rationale Evaluation

2. Show 8. Perform 2. Promotes fetal lung

no further continuous fetal maturity if delivery
cervical heart rate occurs
changes monitoring
3. Provides
3. Dependent: neuroprotection for
Verbalize fetus <32 weeks
1. Administer
understan
tocolytic 4. Maintains hydration
ding of
medications as and prevents
treatment
plan ordered dehydration-induced
(Nifedipine) contractions
2. Administer 5. Ensures readiness
corticosteroids as for neonatal
ordered resuscitation
(Betamethasone
12 mg IM) Collaborative:
1. Monitors cervical
3. Administer
changes and labor
magnesium sulfate
progression
as ordered for
neuroprotection 2. Ensures NICU
readiness for preterm
4. Administer IV
fluids as prescribed infant
3. Tracks
5. Prepare for
effectiveness of
possible
interventions
emergency
delivery
Collaborative:
1. Coordinate with
physician for serial
cervical
examinations
2. Notify
neonatology team
of potential preterm
delivery
 Assessment Diagnosis Planning Intervention Rationale Evaluation

3. Coordinate with
laboratory for
follow-up tests

APPLICATION OF NURSING THEORIES

1. Dorothea Orem's Self-Care Deficit Theory

Application to Preterm Labor Case:

Orem's theory identifies three categories of self-care requisites: universal, developmental, and health deviation.
In this case, M.R.S. experiences health deviation self-care requisites due to preterm labor.

Self-Care Deficit:

• M.R.S. has limited ability to manage preterm labor independently (knowledge deficit about warning
signs, inability to stop contractions)
• She requires professional nursing intervention to meet health-deviation self-care demands

Nursing Systems Applied:

1. Wholly Compensatory System (acute phase):

o Nurse administers medications (tocolytics, corticosteroids, magnesium sulfate)
o Continuous fetal and maternal monitoring
o Patient completely dependent on nursing care during active preterm labor
2. Partially Compensatory System (stabilization phase):
o Patient participates in care: performs self-monitoring of contractions, uses relaxation techniques
o Nurse provides education and supervises care activities
o Shared responsibility between nurse and patient
3. Supportive-Educative System (discharge planning):
o Teach patient to recognize warning signs of preterm labor recurrence
o Educate about activity restrictions, adequate hydration, stress management
o Patient capable of self-care with guidance and support

Nursing Interventions Based on Orem's Theory:

• Assess patient's self-care deficits and capabilities

• Provide complete care during acute preterm labor
• Gradually transition to supportive-educative role as patient stabilizes
• Teach self-monitoring skills for home management
• Empower patient to participate in decision-making about care
2. Ramona Mercer's Maternal Role Attainment Theory

Application to Preterm Labor Case:

Mercer's theory describes the process by which a woman achieves maternal identity and competence. Preterm
labor disrupts this normal progression and creates role strain.

Impact of Preterm Labor on Maternal Role Attainment:

1. Anticipatory Stage Disruption:

o M.R.S.'s expectations of normal pregnancy progression are threatened
o Fear and anxiety about premature motherhood
o Concerns about ability to care for potentially ill preterm infant
2. Formal Stage Challenges:
o Hospitalization separates mother from her first child
o Limited ability to prepare nursery and practical arrangements for new baby
o Disrupted bonding process due to medical interventions and monitoring
3. Maternal Identity Crisis:
o Guilt feelings: "Did I cause this by working too much?"
o Sense of failure in maintaining pregnancy
REFERENCES:

American College of Obstetricians and Gynecologists. (2021). Preterm (premature) labor and birth: Resource
overview. [Link]

Cunningham, F. G., Leveno, K. J., Bloom, S. L., Dashe, J. S., Hoffman, B. L., Casey, B. M., & Spong, C. Y.
(2022). Williams obstetrics (26th ed.). McGraw-Hill Education.

Davidson, M. R., London, M. L., & Ladewig, P. A. (2020). Olds' maternal-newborn nursing & women's health
across the lifespan (11th ed.). Pearson.

Dutta, D. C. (2020). DC Dutta's textbook of obstetrics (8th ed.). Jaypee Brothers Medical Publishers.

Herdman, T. H., Kamitsuru, S., & Lopes, C. T. (Eds.). (2021). NURSING diagnoses: Definitions and
classification 2021-2023 (12th ed.). Thieme.

Lowdermilk, D. L., Perry, S. E., Cashion, K., & Alden, K. R. (2020). Maternity & women's health care (12th ed.).
Elsevier.

March of Dimes. (2022). Preterm labor and premature birth: Are you at risk?
[Link]

Mercer, R. T. (2004). Becoming a mother versus maternal role attainment. Journal of Nursing Scholarship,
36(3), 226-232. [Link]

Murray, S. S., McKinney, E. S., Holub, K. S., & Jones, R. (2019). Foundations of maternal-newborn and
women's health nursing (7th ed.). Elsevier.

Orem, D. E. (2001). Nursing: Concepts of practice (6th ed.). Mosby.

Pillitteri, A. (2018). Maternal and child health nursing: Care of the childbearing and childrearing family (8th ed.).
Wolters Kluwer.

Resnik, R., Lockwood, C. J., Moore, T. R., Greene, M. F., Copel, J. A., & Silver, R. M. (2019). Creasy and
Resnik's maternal-fetal medicine: Principles and practice (8th ed.). Elsevier.

Simhan, H. N., & Caritis, S. N. (2007). Prevention of preterm delivery. New England Journal of Medicine,
357(5), 477-487. [Link]

World Health Organization. (2023). Preterm birth. [Link]

birth
 PRETERM LABOR

A Case Study
Presented to
The Faculty of the School of Nursing
PHINMA UNIVERSITY OF ILOILO

In Partial Fulfillment
of the Requirements for NUR 146
Care of Mother and Child at Risk or with Problems (Acute and Chronic) - RLE

Asiong, Angel Faith P.

Bacaoco, Charmelle Dayanne C.
Espinosa, Jamilla M.
Gorantes, Ailen Faith S.
Gumao, Kyan Jay O.
Pananganan, Xavier Louise L.
Perante, Jeanescil P.

UI-FA1-BSN2-5
S.Y. 2025-2026