When a woman enters preterm labor, she experiences regular uterine contractions that cause the cervix to thin out and/or dilate early. Preterm labor is defined as labor that begins earlier than 37 weeks into the pregnancy. If the baby is born between 20 and 37 weeks, it is considered a preterm birth.
Preterm birth can result in serious consequences. The baby may not have had enough time in the womb to fully mature. Essential organs and systems may not be ready to sustain the baby outside its mother without medical intervention.
The earlier the baby is born, the more at risk he or she is for complications. Some babies born prematurely have serious health problems, including long-term physical and learning disabilities.
Risk Factors for Preterm Birth
Some pregnancies are more at risk for a preterm birth than others. Some factors that increase risk are:
- Being underweight during the pregnancy
- Smoking, drug, or alcohol abuse during pregnancy
- Having a history of preterm birth
- When the pregnancy is less than two years since the last pregnancy
- Having a short cervix
- Prior surgery on the cervix or uterus
- Multiple pregnancy
- Vaginal bleeding
Can I Reduce My Risk for Preterm Birth?
There’s no 100% foolproof method for preventing a preterm birth. It is important that your physician assesses your risk, and the subsequent precautions are followed. If you are at risk, often times the patient will also see a physician who specializes in high-risk pregnancies. There are some medications available to help prevent some preterm births, but these prescriptions are made on a case-by-case basis.
Symptoms of Preterm Labor
Preterm labor often needs immediate attention. Please call your doctor immediately if you have one or more of these symptoms.
- Increase or change in vaginal discharge – a significant increase in discharge or a change in vaginal discharge (mucous, bloody, or watery) might indicate pre-term labor.
- Pressure in lower abdomen
- Dull aches in the lower back
- Contractions or uterine tightening at regular intervals, with or without pain
- Ruptured membranes or water breaking – this may occur as a gush or as a slow trickle
What Will Happen if I am in Preterm Labor?
Your doctor will perform diagnostic tests and a pelvic exam, possibly a few times over a certain period of time. A transvaginal ultrasound may also be performed to check the dilation of the cervix. Your vaginal discharge will likely be tested for fetal fibronectin, which is a protein commonly found in preterm births. You may need to be hospitalized or visit a specialist immediately.
Even after testing, it still may be unclear if preterm labor will progress to preterm birth. In fact, only 10% of women who enter preterm labor go on to give birth in the next week. You may receive treatment to delay the preterm labor, but for about one-third of women, preterm labor ends naturally.
However when preterm labor does continue, your doctor will provide you with instructions that best tailors your health and the health of your baby.
What Treatments are Available for Preterm Labor?
Certain medications may be prescribed to handle your specific case and increase your baby’s chance of survival. Common treatments include:
These are drugs injected into the placenta and are designed to accelerate the growth of the baby’s brain, lungs, and digestive system. They can be quite helpful in increasing your baby’s chance of survival outside the womb should a preterm birth occur. Typically, these drugs are given between 24 and 34 weeks of pregnancy.
If you are 31 weeks pregnant or less and are at risk of delivering the baby within the next day or so, magnesium sulfate may be given to reduce the risk of cerebral palsy, which is a common risk of preterm birth.
These can delay delivery for up to two days. They may be used to increase the amount of time for magnesium sulfate and corticosteroids to do their work.
There are times when preterm birth cannot be avoided. In these cases, you should expect the highest standards of care from a specialized team of health care experts, including a neonatologist. Your baby may spend time in the Neonatal Intensive Care Unit (NICU) until he or she is strong enough to survive on its own.