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Overview

  • Preterm or premature labour starts before 37 weeks of pregnancy. It’s when your body starts getting ready for birth too early.
  • The earlier preterm birth happens, the greater the health risk for your baby.
  • Many preterm (preemies) need special care in the neonatal intensive care unit.
  • Contraction in preterm labour can be similar to those at full term. However for many women they may be less painful and experienced as pain or cramps. Preterm contractions are usually regular and consistent in length.
  • Preterm birth is the predominant reason for infant mortality.
  • An estimated 15 million babies are born preterm every year across the world. This comes down to more than 1 in 10 babies.

Causes

”The aetiology of preterm labour remains unknown, prediction lacks specificity, prophylaxis is unhelpful, diagnosis is difficult and the benefits and risks of tocolytic therapy are still being debated”

Known causes of preterm labor are:

  • Infection
  • Vaginal bleeding
  • Stress
  • Smoking or drinking
  • Having health conditions, such as high blood pressure, diabetes, blood clotting disorders
  • Being pregnant with baby from in vitro fertilization
  • Being pregnant with twins or multiple
  • Family history of premature labor
  • Too much amniotic fluid (Polyhydramnios)
  • Short interval between pregnancies

Symptoms

  • Contraction, every 10 minutes or more
  • Cramping in lower abdomen or menstrual like cramps
  • Backache, usually will be in lower back
  • Fluid leaking from vagina
  • Increased pressure in pelvis or vagina
  • Increased vaginal discharge
  • Vaginal bleeding

Diagnosis

  • An electric monitor is used to check how often contractions are happening and how long they last. This monitor has a small device (transducer) placed over your belly with the belt. Transducer detects and sends information about the contractions to the monitor. Baby heart rate is also monitored.
  • Testing for fetal fibronectin. A swab of cervical or vaginal fluid is checked for fetal fibronectin. Vaginal fluid is a protein found between amniotic membrane and uterine lining. If it is found, it may be a sign of preterm labor.
  • A transducer placed inside the vagina for a transvaginal ultrasound exam. The exam lets your doctor measure the length of your cervix.
  • Testing for amniotic fluid.

Treatment

  • Bed rest
  • IV fluids
  • Cervical cerclage
  • Tocolytic medicines – These slow or stop labour contraction
  • Antenatal corticosteroids (ACS) – These speedup your baby’s lung development
  • Antibiotics – kill infection caused by bacteria

Reference

  • Studd JWWLamont RF, Elder MG (1996) The prevention of preterm birth. in The yearbook of the RCOG. ed Studd JWW (RCOG Press in association with Parthenon Publishing Group, London), pp 369–382.
  • Preterm Birth Prevention And Management by Vincenzo Berghella