What are the common signs?
What are preterm labor and preterm birth?
If you start having regular contractions that cause your cervix to begin to open before you reach 37 weeks of pregnancy, you’re in preterm labor. (It’s also known as premature labor.). If you deliver your baby before 37 weeks, it’s called a preterm birth and your baby is considered premature. Going into preterm labor does not mean you’ll have a premature baby. Up to half of the women who experience preterm labor eventually deliver at 37 weeks or later.
Why does premature birth happen?
About a quarter of preterm births are planned. If you or your baby have a complication and are not doing well, your medical team might decide to deliver you before 37 weeks. This might happen if you have a serious medical condition, such as severe or worsening pre-eclampsia (raised blood pressure) or if your baby has stopped growing. The rest are known as spontaneous preterm births. You may end up having a spontaneous preterm birth if you go into labor prematurely, if your water breaks early or if your cervix(neck of womb) opens prematurely with no contractions. If you’ve already had a preterm baby, though it’s only a slightly higher risk, and many mums go on to have a baby at term. If you have a low income and lack support during your pregnancy. That’s especially the case if you bend over for more than an hour a day in later pregnancy. Your employer has a duty to protect you from working in hazardous conditions, smoking, taking drugs and being underweight may increase your risk. However, being overweight can increase your risk of complications, which may lead to premature birth. Pregnancy problems linked with early labor include: a bacterial infection in your vagina, heavy bleeding during pregnancy an abnormality of the uterus(womb) or cervical weakness. If you have unusual vaginal discharge at any stage, see your doctor.
What could happen if my baby is premature?
Preterm birth can cause serious health problems or even be fatal for a baby, particularly if it happens very early. In general, the more mature a baby is at birth, the better his chances of surviving and being healthy. Some preterm babies may have problems breathing. Prematurity also puts a baby at a greater risk for brain hemorrhage. The nervous system, gastrointestinal tract, and other organs may be affected too. Preterm babies are more prone to infection and jaundice and may have difficulty feeding as well as trouble maintaining their body temperature.
Survivors sometimes suffer long-term health consequences, including chronic lung disease, vision and hearing impairment, cerebral palsy, and developmental problems.
Though they still face a higher risk of problems than babies who are born later in pregnancy.
If you go into labor before 34 weeks and there’s no medical reason for an immediate delivery, your medical team may be able to delay your labor for a few days. This means your baby can be given corticosteroids to help his lungs develop faster, which boosts his chance of survival.
Many technological advances have been made to help treat preterm infants. To take advantage of these, a preterm infant is best cared for at a hospital with a neonatal intensive care unit.
Signs and Symptoms of Premature Labor
Premature labor is usually not painful, but there are several warning signs and symptoms:
- Contractions in your uterus every 10 minutes or more often
- Tightening or low, dull backache that may be constant or come and go, but changing positions and other comfort measures don’t ease it
- Menstrual-like cramps or lower abdominal cramping that may feel like gas pains, with or without diarrhea
- Increased pressure in your pelvis or vagina
- Increased vaginal discharge
- Leaking of fluid from the vagina
- Vaginal bleeding
- Flu-like symptoms such as nausea, vomiting, or diarrhea
- Less movement or kicking by your baby
Call your doctor right away if you have:
- Vaginal bleeding.
- Sudden increase of vaginal discharge.
Check for contractions if you have any of these signs of premature labor:
- Low, dull backache.
- Pelvic or vaginal pressure.
If you have contractions every 10 minutes or more often that do not go away within an hour after changing your position, relaxing, or drinking two to three glasses of water, call your health care provider. Also, call your health care provider if the warning signs listed above worsen or if pain is severe and persistent.
After discussing your signs of premature labor, your doctor may tell you to go to the hospital. Once you arrive, a doctor or nurse will:
- Put a monitor on your abdomen to check your baby’s heart rate and your uterine contractions.
- Check your cervix to see if it is opening.
What will happen when my baby is born?
If your baby is born:
- Early from 34 to 36 weeks he may not need any treatment. He may look small but still be able to go straight to the postnatal ward with you. Or he may be admitted with you to a transitional care ward. It will depend on how he is feeding, and whether he has problems with blood sugar levels, blood pressure or infection.
- Moderately early 32 and 34 weeks, he may need specialized care, as he may have problems with feeding or breathing. Your baby may be able to stay with you on a transitional care ward, or be taken straight to a local neonatal unit or special care baby unit (SCBU).
- Very early between 28 and 31 weeks, he is likely to be cared for in a SCBU or LNU. He will be stronger than younger babies but still at risk of hypothermia, low blood sugar and infection. He may need more specialized care at a neonatal intensive care unit (NICU).
- Extremely early less than 27 weeks he will need to be cared for in a NICU which may mean he’ll be moved to another hospital. He is at high risk of hypothermia, low blood sugar, low blood pressure and infection, and will need help with his breathing.
If your baby needs immediate care, you may only have a brief glimpse of him before he’s whisked away. This can be frightening, and you will need lots of support. Once your baby is stable, you can see him as often as you like. There are lots of things that you can still do for him, such as change his nappy, stroke him, talk to him, and perhaps hold and feed him if the doctors allow you. Babies born before 23 weeks or 24 weeks are unlikely to survive. But doctors will do their best to make sure that your baby is as comfortable as possible. Decisions like these are very hard for parents and doctors to make, which is why clear guidelines have been created.
Whatever the situation, your baby needs the special comfort that you and his dad can give him just as much as he needs medical help.
Dr. Gasser El Bishry MBBCh, MSc, MRCOG
Professor Obstetrics & Gynaecology, Ain Shams University, Cairo Consultant Obstetrician & Gynaecologist, Durham, UK. Member of the Royal College of Obstetricians & Gynaecologists, UK. Advanced Obstetric Ultrasound Diploma, London, UK. Member of the British Endoscopic Society, UK.
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