Preterm labor or premature labor is when your body gets ready for the birth of your baby too early than the expected due date. Learn the causes of preterm labor and know how it can be managed.
Last Updated: Oct 22, 2020 11:29 GMT
Preterm labor is defined as regular contractions of the uterus that results in changes in the cervix before 37 weeks of pregnancy. Preterm labor can result in premature birth. Premature birth can happen after week 20 and before 37 weeks of pregnancy. Premature babies may not be fully developed and may face complications including physical and learning disabilities. It is estimated by the World Health Organization that approximately 15 million babies are born preterm every year. Based on the gestational age, preterm birth is categorized into
· Extremely preterm (less than 28 weeks)
· Very preterm (28 to 32 weeks)
· Moderate to late preterm (32 to 37 weeks).Who is at risk of preterm labor?
Some of the risk factors of preterm labour are listed below.
· Smoking and use of illicit drugs
· Maternal age less than 20 or more than 35
· Overweight or underweight before pregnancy
· Any family history or personal history of preterm delivery
· Multiple pregnancy (twins, triplets)
· Shortened cervix
· Abnormally shaped uterus
· Placenta in an abnormal position
· Chronic health conditions like high blood pressure, diabetes and autoimmune diseases
· Polyhydramnios- amniotic fluid too high
· Vaginal bleeding during pregnancy
· If the pregnancy interval is less than 12 months or more than 59 months
· Problems with fetal growth and chances of birth defectsSigns and Symptoms of preterm labor
The following are the signs and symptoms of preterm labor.
· Frequent Contractions
· Constant low backache
· A feeling of pelvic or lower abdominal pressure
· Mild abdominal cramps or menstrual like cramps
· Vaginal spotting or light bleeding
· Premature rupture of membranes
· Changes in type and amount of vaginal discharge (Blood, mucus or watery fluid)
· Increased pressure in vagina or pelvis
Seek immediate medical attention if you have the symptoms of preterm labor.
Diagnosis of preterm labor
Based on your signs and symptoms, certain diagnostic tests will be performed. If you tend to have uterine contractions and your cervix has begun to soften and thin, before 37 weeks of pregnancy you may have a chance of undergoing a preterm delivery.
The following procedures may help to identify the chances of preterm labor.
1. Pelvic Examination: Your doctor may perform a pelvic examination to assess the firmness and tenderness of your uterus and check the baby's size and position. Your doctor will also evaluate whether cervix has begun to open and if there are chances of uterine bleeding.
2. Ultrasound: A transvaginal ultrasound will be done to measure the length of cervix. An ultrasound will also help determine the baby’s position, volume of amniotic fluid and estimating your baby’s weight.
3. Uterine monitoring: The duration and spacing of contractions will be monitored with the help of a uterine monitor.
4. Lab tests: Levels of fetal fibronectin will be measured in the vaginal discharge and the possibility of infections will also be evaluated.Treatment
Corticosteroids: Your doctor may recommend corticosteroids to help promote the maturity of your baby’s lungs, brain and digestive organs. Corticosteroids are often recommended if you are likely to deliver a baby in the next seven days and if your pregnancy is between 23 and 34 weeks.
Magnesium Sulfate: If you are less than 32 weeks pregnant, and if you have the chance of delivery in the next 24 hours, magnesium sulfate can be used to lower the risk of cerebral palsy.
Tocolytics: Tocolytics help to slow down the contractions. It may be used to delay preterm labour for upto 48 hours.
Cervical cerclage: If short cervix (less than 25mm) can be the cause of your preterm labor, a surgical procedure called cervical cerclage will be performed. In this procedure, the cervix is stitched closed with strong sutures and the sutures are removed after 36 completed weeks of pregnancy.Complications of preterm labour
Preterm labor results in preterm birth. The ambience of a mother’s womb cannot be mimicked by any specialized intensive care units. Premature babies grow slower than full term babies. Babies born before 25 weeks have higher chances of health issues like autism, intellectual disabilities, cerebral palsy, lung problems, and vision and hearing problems. They require specialized care at neonatal intensive care units.Preventing preterm labor
Preterm labor cannot be prevented. But having good prenatal care and following some lifestyle modifications can help prevent preterm labor.
· Have good prenatal care. Learn the symptoms of preterm labour and if you suspect you have any symptoms, seek immediate medical advice.
· Have a healthy diet.
· Quit smoking and never use illicit drugs.
· Always have planned pregnancies. You can discuss with your healthcare provider about pregnancy spacing.
· If you have high blood pressure and diabetes, keep them under control.
· If you plan to conceive through assisted reproductive technology, do know how many embryos are inserted as multiple embryos increases the chance of preterm labor.