All about premature labour

What is classed as premature labour
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

NOSEBLEED

NOSEBLEED
A nosebleed can occur following a blow to the nose, or from picking it.
1. Pinch the soft part of the child’s nose and ask them to lean forward. Pinching the nose will help the blood to clot. Ask the child to breathe through their mouth and to spit out any blood in their mouth. Continue to pinch the soft part of their nose for ten minutes.
2. Seek medical advice if the bleeding continues for more than half an hour.

Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.

MENINGITIS

MENINGITIS
The baby or child may have flu-like symptoms, a headache and a high temperature. They may also complain of a stiff neck and be sensitive to light. At a later stage, a rash may form (that does not disappear when a glass is pressed against it). Other symptoms include: cold hands and feet, joint pain, drowsiness and vomiting. A baby or child with meningitis can have one or more symptoms, and some symptoms occur later on as the infection develops.
1. If you observe any of these symptoms, call 999. A baby or child with meningitis can deteriorate very quickly. It is potentially very serious and needs immediate attention. Do not wait for all the symptoms to occur.
2. Give them constant reassurance while waiting for the ambulance.
3. If they have a fever, you can give them cold drinks to cool them down.


Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.

HEAD INJURY

HEAD INJURY
A blow to the head may result in the baby or child having pain or a headache. There may be a bump on their head and they may look pale.
1. Get the baby or child to rest and apply something cold to the injury (e.g. frozen vegetables wrapped in a tea towel). Applying something cold to the injury will reduce external swelling and pain. In addition to external swelling, when a baby or child suffers a blow to the head, this may result in a more serious head injury (e.g. concussion), which may make them feel sick or drowsy.
2. If they become drowsy or vomit, or their condition deteriorates, call 999. This could be a sign of a serious injury to the head.

Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.

FEBRILE SEIZURE

FEBRILE SEIZURE
Febrile seizures are caused by a fever or high temperature.
1. The child may arch their back, stiffen their body and have clenched fists. They look red-faced, are hot to touch and sweating. Their eyes may roll upwards and they may hold their breath.
2. Protect the child from injury. Do not restrain them. Remove objects that may injure the child while they are having the seizure. Use a blanket or clothing to protect their head from injury.
3. Remove outer clothing to help cool them. Febrile seizures are caused by a raised temperature so it is important to cool the child. If the room they are in is hot, ensure there is a flow of fresh air (e.g. open a window).
4. When the seizure is over, help the child to rest on their side with their head tilted back. If the symptoms continue or it is their first seizure, seek medical advice. Helping them to lie on their side with their head back will help them to keep breathing.


Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.

EPILEPTIC SEIZURE

EPILEPTIC SEIZURE
The child has collapsed and is making sudden jerking movements. They may also have froth around their mouth.
1. Use a blanket or clothing to protect their head from injury. Do not restrain them. Restraining them may cause injury to you or them. Let the seizure run its normal course. Remove objects that may injure the child while they are having the seizure.
2. When the seizure is over, help the child to rest on their side with their head tilted back. Helping them to lie on their side with their head back will make sure they keep breathing.
3. Call 999 if necessary.

Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.

CROUP

CROUP
The child has difficulty breathing, and a short barking cough. Their cough may also sound like crowing or whistling. In severe attacks, the child may use muscles around their nose and neck as they struggle in their attempts to breathe. They may also have blue-tinged skin.
1. When you observe these symptoms, sit the child up and create a steamy atmosphere by boiling a kettle or running a bath.
2. Sitting them up may help them to breathe easier. Reassure the child, as they may be frightened.
3. Encourage the child to relax enough to breathe in the steam, and if the symptoms continue seek medical advice. Breathing in the steam may ease the child’s cough and help them breathe more easily.


Please remember that amongst the *Mums World* team there are NO medical professionals. Information has been collated from reputable websites which will be listed at the end of the topic. If you are in doubt we recommend talking to your GP, midwife/health visitor or in more urgent circumstance contact NHS Direct.