Signs of Preterm Labor – Ways to Prevent or Treat This Pregnancy Complication
Carrying a child in the womb and completing the course of 9 months is no less than a challenge. This course of time is crucial for the perfect growth and development of the bundle of joy you are eagerly waiting for. While most of the babies want to linger around in the womb till they get fully mature, some others are in a rush to come out into this world.
This early expulsion or birth of the child is due to preterm labor that the mom faces during pregnancy. This can lead to several complications in a child. Let’s know why it happens and how can a woman avert this pregnancy complication.
Also called as premature labor, is one of the serious and distressing situations a woman can face during pregnancy. It means that your body is preparing for delivering before the appointed time. Preterm labor occurs when a woman feels regular contractions followed by the opening of the cervix after 20 weeks and before the 37th week.
Premature labor can result in premature delivery that can render several complications in the newborn including physical and mental disabilities. According to statistics, India bears the highest burden, about 35 percent of the total premature births in the world.
Causes and risk factors - Why preterm labor occurs?
Experts haven’t deciphered the exact cause of preterm labor yet, but there are risk factors which might play spoilsport. While some women are at greater risk of facing preterm labor, this can happen to anyone without any risk factors. Here are some of the risk factors of premature labor every prospective mother should know about:
- History of premature labor, especially in the recent pregnancy
- Uterine, cervical and placental problems
- Carrying multiple pregnancies
- Chronic problems such as diabetes, kidney disease, and high blood pressure
- Excess of amniotic fluid (polyhydramnios)
- Smoking, taking alcohol or illicit drugs
- Birth defect in the fetus
- Infection in the amniotic fluid, uterus or genitals
- Gap of less than 6 months between two pregnancies
- Being pregnant with IVF
- Vaginal bleeding
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Early signs and symptoms – How can a pregnant woman know about preterm labor?
Premature labor warning signs can help you and your doctor acts fast to prevent premature delivery. Many women think as they are not near the due date, they can’t be in labor. This misapprehension can create troubles for them. If you are experiencing any of the following symptoms, call the doctor right away.
- Regular contractions or abdominal tightening (five or more in an hour)
- Backache or dull pain in the lower back
- Cramps in the lower abdomen similar to menstrual cramps that may accompany diarrhea
- Sudden discharge of clear, watery or mucus-like fluid from the vagina
- Vaginal bleeding which appears bright red in color
- Abdominal pressure
- Previous surgery performed on the cervix
- Preterm rupture of membranes
Pregnant women should keep in mind that sometimes it can happen that they would get false labor contractions or false labor pain known as Braxton Hicks. These contractions are usually temporary, not painful and shut down when you change your position like move around or take rest.
This normally happens during the second or third trimester. If you are not sure how to differentiate, call your doctor or midwife.
Complications of preterm labor
The longer (within 9 months) your baby remains in the womb, the better are the chances of getting a healthy child. Babies born prematurely can come with serious complications including:
- Low birth weight
- Breathing difficulties
- Learning difficulties
- Vision problems
- Underdeveloped organs
Majority of the babies born before 24 weeks have minimal chances of survival. However, babies born after 32 weeks have higher survival rate.
Diagnosis of preterm labor
After reviewing your symptoms, the doctor will ask about your medical history for any risk factors. If you are facing regular cramps and contractions followed by softening of the cervix, you may be diagnosed with preterm labor. For confirmation, the doctor may conduct:
- Pelvic examination – This will check for tenderness, firmness of the uterus as well as check for cervix for dilation (widening)
- Ultrasound – It will be used for determining the length of the cervix, placenta problems and also assessing baby’s position and amniotic fluid volume
- Uterine monitoring - The doctor may put you on uterine monitoring device to check for duration and time gap between the contractions
- Lab examination – The doctor might also take a swab of the vaginal secretion to check for any infection. You might also be asked to provide a sample of urine to check the presence of any bacteria.
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Is there any treatment available for preterm labor?
Once a woman enters or shows the signs of labor, there is actually no way to turn the things around. Even the latest medical interventions can delay the labor a couple of days and not more than that. This window lets the pregnant women admit into the hospital and help the team of doctor complete the rest of the process carefully.
During the treatment at the hospital, the doctor can recommend following:
- Corticosteroids – If the pregnancy is between 24-34 weeks, the woman would get steroid injections such as betamethasone for boosting the development of baby’s lungs.Women with diabetes are carefully monitored after steroid injections since it can create problems especially when given with combination of beta-mimetic drug such as terbutaline.
- Tocolytics – These medications temporarily slow down or stop contractions. Tocolytics including calcium channel blockers (CCBs) such as nifedipine (Procardia), ritodrine, indomethacin, etc. can hold premature labor for no more than 2 days. Women with high blood pressure (preeclampsia) and placental abruption should not take tocolytics.
- Magnesium sulfate – In women with high risk of delivering the baby in 24-32 weeks, the doctor can also recommend magnesium sulfate. This medication which is a subset of tocolytics is given intravenously. It serves two purposes; one preventing seizures in the mother and second to prevent certain brain disorders such as cerebral palsy.
- Cervical cerclage – This is a surgical procedure conducted on women with short cervix (less than 25mm) or those who are 24 weeks pregnant or history of premature labor. This treatment may work depending on whether the labor has begun or not.
Are there any preventive measures of preterm labor?
Not all the cases of preterm labor can be prevented. However, you can work with your doctor and do a whole lot of things during pregnancy to delay preterm labor as much as possible:
Medical preventive techniques
Progesterone injections - For women with history of premature birth, the doctor can recommend shots of hydroxyprogesterone caproate(17-OHPC) in the second trimester or 21st week of pregnancy. The injections need to be continued till the 37th week of pregnancy.
Antibiotics – Women with the history of premature rupture of membranes might be given antibiotics to prevent infection in the uterus which can lead to preterm birth. Some of the most commonly used antibiotics are clindamycin, erythromycin, gentamicin, ampicillin, and metronidazole. Antibiotics might also help in prolonging the pregnancy.
- Staying well hydrated
- Eating a healthy well-balanced diet
- Going through regular prenatal care
- Avoiding the use of harmful substances such as smoking, alcohol or illicit drugs
- Avoiding stressful physical activity
The early the baby is born, the more are the chances of him/her coming up with problems. So do what the best and recommended by your gynecologist. Seek help immediately if you notice any specific sign or symptoms.