Nursing care for pregnant women with hypertension and premature birth

Abstract

Hypertensive disorders of pregnancy are severe complications affecting multiple organ systems, primarily resulting from abnormal placental pathophysiology. Without timely and appropriate management, these conditions can lead to significant maternal and neonatal morbidity and mortality. At Singburi Hospital, the incidence of hypertensive disorders in pregnancy from 2021 to 2023 was 2.80%, 1.94%, and 2.60%, respectively. This study focuses on parturients with hypertension who enter the labor process, a condition associated with an increased risk of preterm birth. The core principle of management is the provision of prompt and effective care to ensure the safety of both mother and infant. A case study approach was employed, and the findings were applied to enhance clinical practice in labor care.

In the presented case, the patient was in a critical condition with a high risk of eclampsia during labor and preterm delivery, both of which could be life-threatening to the mother and newborn. Labor room nurses must be competent in early recognition and assessment of critical conditions, performing timely initial interventions based on clinical standards, effectively communicating and coordinating with multidisciplinary teams, and implementing holistic care that addresses both physical and psychological needs to promote safe outcomes. In this case, the woman with hypertensive disorder and preterm labor received prompt initial assessment, early diagnosis, notification of the obstetrician and pediatrician, and coordinated emergency care.

Labor room nurses play an essential role in assessing risks in pregnant women with hypertension and preterm labor, providing evidence-based nursing care, preparing healthcare teams, equipment, instruments, and medications, and assisting physicians with necessary procedures, including preparation for emergency cesarean section when indicated. This case underscores the importance of timely, systematic, and well-coordinated nursing management in improving maternal and neonatal outcomes in high-risk obstetric conditions.