One of the most exciting moments for an expectant mom is the day when she finally meets her child. This is why many moms-to-be always look forward to the day when they will give birth. However, sometimes even when you’re very near your due date, unexpected things can still happen. One of these is when the baby seems to want to come out earlier than expected. This condition is called premature or preterm labour.
Premature labour is when a pregnant woman experiences labour pains or uterine contractions while the cervix starts to thin and open. This condition usually happens before the 37th week of pregnancy.
Preterm labour can lead to premature birth, which can be fatal to a newborn baby. The World Health Organization estimates that 15 million babies are born premature and approximately one million children die each year due to complications of premature birth.
What are the signs and symptoms of preterm labour?
If you have at least one of the following signs and symptoms, inform your doctor immediately:
- Frequent contractions, especially if more than 4 in an hour, that are either painless or feel like menstrual cramps
- Constant backache
- Pressure in lower abdomen
- Vaginal discharge, which may be in a form of blood, mucus, or water fluid
- Diarrhea or upset stomach
- Gush of fluid from the vagina, which can be a sign that your water bag has broken
“The contractions usually happen hourly, then the interval in between shortens, until it becomes every two to three minutes,” says Dr. Katleen del Prado, an obstetrician-gynecologist from Lucena City, Philippines.
She further describes, “The pain is like the pain we feel during menses in the lower belly and radiates to the lower back. There is water or bloody-mucoid type of vaginal discharge. These are contractions of the uterus and opening up of the cervix upon digital internal examination by the doctor.”
What causes preterm labour?
Infections are the most common causes of preterm labour. These may include urinary tract infections (UTI) and cervico-vaginal infections. Dr. del Prado notes, “Infections elsewhere, like in the lungs or in the mouth for periodontal disease, can trigger preterm labour.
Other causes are:
- Uterine stretch, which happens when there is too much fluid or the fetus is too big. Uncontrolled diabetes mellitus can cause an increase in amniotic fluid.
- Cervical incompetence, where the cervix opens up without uterine contractions. According to Dr. del Prado, “This is actually not under the classification of preterm labour but it is a very significant cause of preterm delivery.”
- Spontaneous preterm birth, which happens when the labour happens on its own and/or the pregnant woman’s water breaks early. This condition causes two thirds of all premature births.
There are also studies that have found a mother’s immunity may play an important role in preterm labour.
These are just some of the many possible causes of preterm labour. Dr. del Prado stresses, “We must understand how labour works. Labour happens because of uterine contractions and opening up of the cervix. The basic mechanism is that of inflammation, muscle stretch, and opening of the cervix--either spontaneously or secondary to the contractions.”
Who is at risk?
As mentioned earlier, uterine stretch can cause preterm labour. This condition is highly possible for pregnant women who are expecting twins or more. Here are other conditions that may put an expectant mom at risk for preterm labour:
- experienced premature labour in a previous pregnancy
- got pregnant too soon after giving birth
- has existing medical conditions like anemia, diabetes, high blood pressure, preeclampsia, and blood clotting disorders
- has problems with the cervix, uterus, and even in the placenta
- got pregnant after in vitro fertilization
- overweight or underweight before pregnancy
- smoking, drinking, and taking of illegal drugs
- lack of or has no prenatal care
- chronic stress
Take note that there are pregnant women who do not have any of these conditions but still experience preterm labour. So, it is important to always know your own medical history and do not miss your regular check up with your doctor.
What exams can be done to diagnose preterm labour?
If you or your doctor suspects that you’re having preterm labour, you may be asked to check into the hospital to undergo some tests. These may include:
- Cervical exam, where your doctor will check your cervix for changes and monitor your contractions.
- Transvaginal exam, which is a type of an ultrasound exam that uses a transducer device placed inside your vagina. This helps your doctor measure the length of your cervix.
- Amniotic fluid test, which determines if the sac around the baby has broken.
According to Dr. del Prado, doctors can help stop or slow down preterm labour by prescribing medicines to delay the delivery and keep the baby in the womb as long as possible. However, she warns, “Choice of medication is highly individualised because there are not without side effects, and hence, cannot be overly prolonged. Response to these medications depends also on the patient, who may or may not be admitted depending on the case.”
Not all preterm labour experiences are the same, so different treatments may be suggested depending on a mother’s medical history, risk factors, and pregnancy experience.
These treatments may include:
- Bed rest, which can be done at home or in the hospital.
- Cervical cerclage, which is a procedure to stitch the cervix closed because it is either weak or not able to stay closed.
- Antibiotics to treat infections.
- Tocolytic medicines to help or slow contractions.
- Corticosteroids, which may help the lungs of the baby to grow and mature since preterm babies’ lungs may not be able to work on their own.
- Early delivery of the baby if the available treatments do not help stop preterm labour or the baby is already in danger. This is usually done via cesarean delivery.
It may be a good idea to learn about maternity insurance, to help you prepare about possible pregnancy outcomes, including preterm labour. Ask an insurance agent if preterm labour is covered in the policy you are interested to avail.
How to prevent preterm labour?
One of the best ways to avoid experiencing preterm labour is getting prenatal care with a high risk pregnancy expert. In this case, you will be able to plan your pregnancy well, control any chronic condition that you have, and make necessary lifestyle changes.
Here are some ways to prevent preterm labour:
- Follow a well-balanced diet and include prenatal vitamins, as well as other needed supplements.
- Treat infections, if you have any, before pregnancy.
- Consult with your doctor to properly manage your pre-existing health conditions such as diabetes and high blood pressure.
- Avoid smoking, drinking alcohol, and taking illegal drugs that can harm you and your baby.
- Maintain an ideal weight before getting pregnant by exercising regularly.
- Always relax and avoid stressful activities and situations.
- Always get enough rest and sleep.
- Practice family planning to avoid getting pregnant too soon after giving birth.
Keep in mind that preterm labour can result in preterm birth, which can put your baby at risk for many health problems after delivery. So, make sure to take care of your health and visit your doctor regularly.
Original Publisher: theAsianparent