Premature labor occurs when your body begins preparing for birth prematurely in your pregnancy, such as through regular uterine contractions and cervical changes occurring before 37 completed weeks of gestation.
Preterm labor can result in the premature delivery of your baby, leading to serious health complications for both you and the infant. The earlier they are born, the greater their impact will be.
What is Preterm Labor?
Preterm labor refers to early contractions which cause your uterus to open and push out your baby before 37 weeks gestation, or as soon as week 20 of gestation. It could happen as soon as 20 weeks or any time before then.
Early labor symptoms are easily misinterpreted as menstrual cramping or backache, so many women do not seek medical assistance until experiencing extreme discomfort that does not subside with rest or changing positions. When that occurs, a doctor will conduct an evaluation in the hospital using an electronic fetal monitor device to see how strong your contractions are and when they occur.
Preterm labor requires doctors to measure both the duration between contractions and how high your fetus’ heart rate is, in addition to monitoring any breathing difficulties upon birth. Therefore, doctors will try and delay labor for as long as possible so as to allow more time for development before birth.
Researchers don’t yet fully understand what causes preterm labor, though certain women are at greater risk than others. Obstetric conditions like shortening of your cervix increase your chance of preterm labor; second trimester miscarriages or pelvic surgery or infections put women of color and younger women more at risk than others for this condition.
What are the Signs and Symptoms of Preterm Labor?
Many mothers desire a pregnancy to reach 37 weeks, but sometimes that’s not possible and preterm labor may begin much earlier than planned. Understanding its signs and symptoms is important in order to stay pregnant safely.
At first sign, there may be an abrupt increase in vaginal discharge or your water breaking. Other indicators could include persistent lower back pain or pressure sensation on your pelvis. If regular and persistent contractions persist after resting and hydrating, contact healthcare provider immediately; otherwise sporadic early contractions that do not hurt can often be misidentified as Braxton Hicks contractions.
Once at the hospital, you’ll likely be hooked up to a fetal monitor and given an exam of your cervix. Your provider may also conduct a vaginal swab to detect whether you’re in early labor using an indicator called fetal fibronectin protein, which helps determine if early labor has begun.
Your doctor may prescribe tocolytic medication to relax your uterus and give the baby more time to develop within you. In addition, bed rest may help reduce gravity’s pressure on the cervix and potentially stop or slow labor from progressing further.
What are the Treatments for Preterm Labor?
Preterm labor and delivery can be treated using medication to either slow down or stop labor altogether, and to assist the baby’s organs prepare for birth. Women should familiarize themselves with the signs and symptoms of preterm labor so they can contact their healthcare provider immediately if they experience them.
Women experiencing more than six contractions an hour should consult with their healthcare provider if they have other signs of preterm labor such as vaginal bleeding and leakage of amniotic fluid. Her healthcare provider will conduct a pelvic exam and transvaginal ultrasound scan to assess where her pregnancy stands and if cervix thinning or diluting are happening (beginning to thin or dilate).
Preterm labor can be caused by several factors, including infections, placenta issues, problems with the uterus (such as polyhydramnios or having multiple babies at once), physical or emotional stress and age (less than 17 or greater than 35), race (black women are more likely to give birth early), family history and previous preterm labor experiences.
If it appears she could be entering preterm labor, her doctor may conduct tests to detect whether there is fetal fibronectin present in her vaginal discharge – this protein helps the amniotic sac adhere to the uterus and may indicate early labor.
What are the Complications of Preterm Labor?
Induced labor or preterm birth can be a catastrophic medical event. Complications that may arise include intracranial hemorrhage, pulmonary embolism, respiratory distress syndrome and inability to maintain body heat (due to immature skin and fat layers). Furthermore, premature newborns may suffer long-term effects such as cerebral palsy or mental retardation due to immature blood vessels being exposed rapidly during preterm labor and experiencing rapid changes in circulation that occur with it.
No one knows for certain what causes most preterm births, but certain factors may increase your risk. These risk factors cannot always be avoided or eliminated completely but, together with your healthcare team, can often be reduced significantly.
Risks associated with preterm birth can be reduced if you receive recommended antenatal care, including regular visits to your physician and leading a healthy diet and lifestyle. Controlling chronic conditions like diabetes and high blood pressure also helps lower the risks.
Certain risks cannot be changed, such as having had a prior preterm birth or being over 35. Race also plays a factor: roughly 17 percent of black babies are born prematurely compared with 10 percent for white and Hispanic infants respectively – although over the last 25 years, premature birth rates have greatly declined.
