Premature labour is going into labour before 37 weeks in pregnancy.
Signs of premature labour
contractions
sudden breaking of the waters
a 'show' (when the plug of mucus that has sealed the cervix during pregnancy comes away and out of the vagina)
Why does premature labour happen
In around 40 per cent of cases, the cause of premature labour is unknown. Other causes include:
pre-eclampsia
multiple pregnancy
antenatal haemorrhage
illness in the mother, such as diabetes, high blood pressure or heart disease
cervical incompetence
foetal abnormalities or death
What happens if baby is born early
If your baby is likely to be delivered early, you will be admitted to a hospital with specialist facilities for premature babies. This is known as a neonatal unit. Find out more about babies who need special intensive care.
Not all hospitals have facilities for the care of very premature babies, so it may be necessary to transfer you and your baby to another unit, ideally before delivery (if time permits) or immediately afterwards.
If contractions start prematurely, the doctors may be able to use drugs (tocolytics) to stop your contractions temporarily. This hopefully allows time for steroid injections to be given. Steroids will reduce the risk of the baby suffering from the complications of being born very early (particularly breathing difficulties and bleeding). They can take about 24 hours to work.
Diagnosis of premature labour
The challenge with premature labour is to spot it before it gets going. The only absolute proof of labour is dilation of the cervix, but by then it's too late to stop the baby being born.
Contractions of the uterus can be a confusing sign. Many women experience Braxton Hicks, or 'practice', contractions from week 24 of pregnancy. Two-thirds of women diagnosed as being in labour won't have delivered within 48 hours and one in three will continue their pregnancy to full term (40 weeks).
If a woman's membranes rupture and she loses amniotic fluid, labour becomes more likely, especially as there's a risk of infection. However, urine may be mistaken for amniotic fluid and even special testing sticks can give incorrect answers.
Research has suggested that some chemicals can give a clue that labour is about to start. One example is foetal fibronectin, found in the secretions in the vagina. However, currently, such tests can only give a rough guide.
Treatments for premature labour
Many things have been tried to halt premature labour, including drugs to stop contractions, ties to keep the cervix from dilating and antibiotics to treat infection. However, none is very effective.
Drugs that stop contractions (tocolytics) help in about a quarter of cases, but rarely work for more than 48 hours. They also carry some risks, especially if the membranes have ruptured. Such drugs are mostly used to postpone delivery until the woman can get to a hospital with a special care baby unit.
At the same time, treatments can be given to prepare the baby for an early arrival, such as drugs to help mature the lungs. These may reduce the risk of complications, halving the severity of respiratory distress syndrome.
Complications of premature labour
Babies born after 34 weeks only have a low risk of problems because their systems have almost completely matured and labour is usually allowed to continue. But those under 28 weeks need to be delivered in a hospital with a neonatal intensive care unit.
In recent years, doctors have been able to improve dramatically the survival hopes for babies born as early as 22 or 23 weeks. However, these babies face a huge battle at the start of life, with a risk of many significant long-term problems.
Premature babies are at risk of:
respiratory distress syndrome
hypothermia
low blood glucose
jaundice
infection
retinopathy of prematurity
necritising enterocolitis
death
Why does my baby need special care unit
Babies can be admitted to neonatal services for a number of reasons:
they are born early – one in 10 babies are born early, and babies born before 34 weeks may need extra help with breathing, feeding and keeping warm
they are very small and have a low birthweight
they have an infection
their mother has diabetes
the delivery was very difficult and they need to be kept under close observation for a time
they have jaundice
they are waiting for, or recovering from, complex surgery
Neonatal care in hospital
About one in eight babies will need extra care in hospital, sometimes on the ordinary postnatal ward and sometimes in a specialist newborn (neonatal) area. Having a baby in neonatal care is naturally worrying for parents and every effort should be made to ensure that you receive the information, communication and support that you need. Not all hospitals provide neonatal services, so it may be necessary to transfer your baby to another hospital.
Preventing premature labour
There's often little you can do to prevent premature labour, but to reduce your risk you should:
stop smoking
get vaginal infections or discharge treated
report symptoms such as swollen ankles, blood loss or fluid loss
keep fit and healthy
avoid excessive stress
The content of our topic tonight on premature is to give you general information and raise awareness only. IF you are concerned on anything with your pregnancy please get checked out by GP or MW as none of us on the *mums world* team are medically trained or medical professionals
All our information was collected together from the nhs and bbc health websites
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