Preterm Labor

1 What is Preterm Labor?

Preterm labor occurs when regular contractions begin to open your cervix before 37 weeks of pregnancy. A full-term pregnancy should last about 40 weeks.

Your baby will have higher health risks if the birth happens early.

Premature babies need a lot of care in the NICU and they may have long term physical and mental disabilities.

The cause of preterm labor is unknown but there are certain risk factors that may play a role in preterm labor.

2 Symptoms

For some women, the signs and symptoms of preterm labor are unmistakable, for others, they're more subtle.

While you are pregnant, you must be look out for:

  • frequent or regular contractions;
  • diarrhea;
  • constant low and dull backache;
  • mild abdominal cramps;
  • a sensation of lower abdominal or pelvic pressure;
  • a change in vaginal discharge;
  • watery vaginal discharge or water breaking;
  • vaginal bleeding or spotting.

If you are bothered by what you are experiencing especially if you have vaginal bleeding, consult your doctor right away.

3 Causes

The cause of preterm labor is unclear. Some experts say that there are factors that could play a role in triggering your uterus to begin contracting early and your cervix to dilate before the baby is ready to come out.

4 Making a Diagnosis

To help diagnose preterm labor, your health care provider will document your signs and symptoms.

Contact your doctor if you are experiencing the symptoms of preterm labor as you might need special care as soon as possible.

Ask your doctor if there are any restrictions that you need to do before the appointment. Ask a family member or a close friend to accompany you in the appointment.

Some of the questions that you can ask your doctor include

  • Am I in labor?
  • What can I do to help prolong my pregnancy?
  • Are there any treatments that you are going to give me?
  • What are the risks if my baby will be born now?

Your doctor will also ask you questions such as

  • When did you first notice the symptoms?
  • Are you having contractions?
  • If so, how many an hour?
  • Do you have vaginal bleeding or discharge?
  • Have you been exposed to infections?
  • Do you smoke? How much?
  • How far do you live from the hospital?

You will be diagnosed with preterm labor if your cervix has begun to soften and open before the 37th week.

Some of the possible tests include:

  • pelvic exam – to check if your water has not been broken and if your cervix has begun to open, and also if you already have placenta previa;
  • ultrasound – this is done to determine the baby’s age, size, positions in the uterus and weight and to measure the length of your cervix;
  • lab tests – to check for certain infections and fetal fibronectin by taikng a swab of your vaginal secretion;
  • uterine monitoring – to measure the spacing and duration of your contractions;
  • maturity amniocentesis – to determine your baby’s lung maturity and by detecting infection by removing the amniotic fluid from your uterus.

Sometimes preterm labor stops on its own.

5 Treatment

There are many different courses of treatment associated with preterm labor. It depends on the severity and level of emergency.

There is a procedure called cervical cerclage that can help prevent premature birth.

The cervix will be stitched to close it with strong sutures and this sutures will be removed when the baby is considered full term or during the 37th week of pregnancy.

Early premature birth is when your cervical length is less than 25 millimeters and if you are less than 24 weeks pregnant, you will need cervical cerclage.

If you're before week 34 of your pregnancy and in active preterm labor, your doctor might recommend hospitalization.

There are medications such as pain relievers and others such as:

  • corticosteroids – steroid injection if you are between 24 and 34 weeks pregnant, but after week 34 your baby’s lungs may be mature enough for delivery,
  • magnesium sulfate – there are research that says this may reduce the risk of cerebral palsy for babies born between 32 weeks of gestation,
  • tocolytics – this is a medication that will stop your contractions but not longer than 2 days because this medication is not for the underlying cause of the preterm labor. You can talk to your doctor about the risks and benefits of using a tocolytic and if you have certain conditions such as pregnancy-induced high blood pressure, your doctor will not approved the use of tocolytic. You may need more visits to the hospital for follow-ups.

6 Prevention

You might not be able to prevent preterm labor, but there are things you can do to promote a full term pregnancy such as:

Seek regular prenatal care

Always go to your doctor for regular check-ups especially if you have signs and symptoms that are bothering you, your doctor mat even recommend tests and exams;

Eat a healthy diet

You will need more calcium, folic acid, iron and other essential nutrients including vitamins during pregnancy;

Consider pregnancy spacing

You are at risk of premature birth if your pregnancies spaced lee than six months apart, ask your doctor about pregnancy spacing;

Avoid risky substances

Quit smoking and avoid illicit drugs for these may increase your risk of preterm labor. If you are going to drink over-the-counter medicines, consult your doctor first;

Be cautious when using assisted reproductive technology (ART)

Ask your doctor how many embryos will be implanted because multiple pregnancies will have high risk of preterm labor. Your doctor will suggest taking additional steps to reduce your risk such as: taking preventive medications – hormone progesterone called hydroxyprogesterone caproate (Makena) is a weekly shot that will be given to you by your doctor if you have a history of premature birth. There is new research that uses a vaginal progesterone gel during the second and third trimesters might decrease the risk of premature birth in women who have short cervixes;

Limiting certain physical activities

Your doctor will recommend that you stay indoors as much as possible to avoid too much time on your feet, avoid lifting heavy objects and to have enough rest;

Managing chronic conditions

High blood pressure and diabetes need to be under control to avoid preterm labor. You should know the early warning signs and symptoms of preterm labor.

7 Alternative and Homeopathic Remedies

One of the homeopathic remedy for preterm labor is Caulophyllum.

Ask your doctor about this before taking it.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with preterm labor.

You can try resting, walking or changing your position if you are having contractions that you suspect that it is a symptom of preterm labor.

Preterm labors will have continuous contractions but this condition is common to pregnant women, it does not mean that your cervix will begin to open.

You might need to drink lots of fluids and have enough rest to ease your stress about your condition and because during these days you might feel anxious or scared especially if you have a history of preterm labor or premature birth.

You can also ask your doctor on ways how to stay calm and relax such as breathing exercises or listening to music or other techniques which can help you reduce anxiety.

9 Risks and Complications

Some of the possible risk factors of preterm labor include:

  • pregnancy with twins, triplets or other multiples,
  • smoking cigarettes or using illicit drugs,
  • previous preterm labor or premature birth, particularly in the most recent pregnancy or in more than one previous pregnancy,
  • some chronic conditions, such as high blood pressure and diabetes,
  • certain problems with the uterus, cervix or placenta,
  • certain infections, particularly of the genital tract,
  • stressful life events, such as the death of a loved one,
  • too much amniotic fluid (polyhydramnios),
  • red blood cell deficiency (anemia), particularly during early pregnancy,
  • being underweight or overweight before pregnancy, or gaining too little or too much weight during pregnancy,
  • presence of a fetal birth defect,
  • pregnancy complications, such as preeclampsia,
  • little or no prenatal care,
  • an interval of less than six months since the last pregnancy,
  • pregnancy complications, such as preeclampsia,
  • having a short cervical length,
  • the presence of fetal fibronectin,
  • gum disease but only a little research about this.

This condition cannot be stopped and this can cause some health problems for your baby such as:

  • breathing difficulties,
  • low birth weight,
  • vision problems and underdeveloped organs,
  • behavioral problems and learning disabilities.

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