I attended an AWHONN meeting and we were talking about PTL and Betamethasone therapy. The physician that was lecturing was saying that for some strange reason, 12 hours or so after administration of Betamethasone, if you have stopped PTL with tocolytics, the pt will begin to contract again for a brief period of time. Just wondering if you guys had seen this happen. I can't seem to recall in the pt's I've taken care of. Usually I don't have them 12 hours after I've given them the shot.
Honestly, it has been a while since I assisted a physician in obtaining a Ffn on a pretermer. I have seen some practitioners use it more than others in guiding their POC. Seems like they rely on cervical dilatation pretty much. I'm still "learning" all the OB's, but thus far I've not seen one wait for a Ffn result before giving the injections. Maybe just to be on the safe side . . . ?
Last I had heard, studies were looking at the validity of results via SSE or just obtaining the specimen from a lady partsl swab. If they determine it does not matter how it is obtained, then I'm willing to wager that nursing will be obtaining these more frequently as the MD will not have to be present.
Will the Ffn be positive if the pt is ruptured?
I had a PROM 25 week pt and a 33 week pt with a cerclage who had come in contracting (resolved after hydration) this weekend. My 25 week pt got Betamethasone and stayed, obviously, and the 33 week pt got one dose and was to return to Triage the next day for her second dose.
Specializes in postpartum, nursery, high risk L&D.
Last I had heard, studies were looking at the validity of results via SSE or just obtaining the specimen from a lady partsl swab. If they determine it does not matter how it is obtained, then I'm willing to wager that nursing will be obtaining these more frequently as the MD will not have to be present.QUOTE]
we just started doing these at our hospital, and it will primarily be the RNs who will be responsible for collecting them, per vag swab. I wish I could remember the stats they gave us as far as accuracy of results versus done via sterile spec....basically there wasn't much difference.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Where I work, we do our own Ffn via SSE. And we tend to collect them early-on, if there is ANY reason to suspect PTL and send down to lab if ordered/indicated.
How many of your practioners are using Ffn results to judge whether steriod use is indicated?
We always collect a FFN by SSE, either by the triage nurse or the Resident if there is one on, for anyone under 34 weeks. If it is neg and there is no cervical change, they aren't treated with steroids.
And yes, if they are ruptured, it will be positive. Can also be positive due to urine, semen, blood.
RaeT,RN
167 Posts
Honestly, it has been a while since I assisted a physician in obtaining a Ffn on a pretermer. I have seen some practitioners use it more than others in guiding their POC. Seems like they rely on cervical dilatation pretty much. I'm still "learning" all the OB's, but thus far I've not seen one wait for a Ffn result before giving the injections. Maybe just to be on the safe side . . . ?
Last I had heard, studies were looking at the validity of results via SSE or just obtaining the specimen from a lady partsl swab. If they determine it does not matter how it is obtained, then I'm willing to wager that nursing will be obtaining these more frequently as the MD will not have to be present.
Will the Ffn be positive if the pt is ruptured?
I had a PROM 25 week pt and a 33 week pt with a cerclage who had come in contracting (resolved after hydration) this weekend. My 25 week pt got Betamethasone and stayed, obviously, and the 33 week pt got one dose and was to return to Triage the next day for her second dose.