What is preterm labor?
Preterm labor (also called premature 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. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date.
When a pregnant woman enters preterm labor, the uterine contractions cause the cervix to thin out, and/or dilate early.
Preterm birth is a pregnancy complication that can result in serious consequences. The baby may not have had enough time in the womb to reach its full growth potential. Essential organs and systems may not be ready to sustain the baby outside its mother without medical intervention.
Some premature babies have serious health problems, like cerebral palsy and other long-term physical and learning disabilities. Risks of preterm labor include delivering a preterm baby. This can pose a number of health concerns for your baby, such as low birth weight, breathing difficulties affecting baby’s lungs, underdeveloped organs, and vision problems.
Many factors can contribute to preterm labor. Although the exact cause of preterm labor is unknown in many cases, one major cause is the premature rupture of membranes (breaking of the amniotic sac).
Risk Factors for Preterm Birth
Some pregnancies have a higher risk of premature birth than others. Factors that increase the risk of preterm labor include:
- Being underweight during the pregnancy
- Smoking, drug, or alcohol abuse during pregnancy
- Previous preterm birth
- When it’s been less than two years since the last pregnancy
- Having a short cervix
- Prior surgery on the cervix or uterus
- Multiple pregnancies
- Vaginal bleeding
- No prenatal care
- Have health conditions, such as diabetes or high blood pressure
Can I Reduce My Risk for Preterm Birth?
There’s no 100% foolproof method for preventing preterm birth. Your health care provider can assess your risk, and give you a set of precautionary measures to follow for a full term pregnancy. Despite the popular belief, bed rest doesn’t seem to help prevent preterm birth and has risks of its own.
If you are at risk, your doctor may refer you to a specialist 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 requires immediate attention. Please call your doctor right away if you have one or more of these symptoms.
- Increase or change in vaginal discharge. A significant increase in discharge or a change in the type of discharge (mucous, bloody, or watery) might indicate pre-term labor.
- Pressure in the lower abdomen
- Low dull backache, back pain
- Pelvic pressure
- Abdominal cramps
- Contractions or uterine tightening at regular intervals, with or without pain
- Ruptured membranes or water(amniotic fluid) breaking. This may occur as a gush or a slow trickle.
What Will Happen if I go into Preterm Labor?
Your doctor will perform diagnostic tests and a series of pelvic exams. A transvaginal ultrasound can check the dilation of the cervix.
Your doctor will also want to test your vaginal discharge for fetal fibronectin, which is a protein commonly found in preterm births. You might also receive an ultrasound to assess the amount of amniotic fluid and to confirm the size and gestational age of your baby. Based on the results, you may need to be hospitalized, or visit a specialist immediately.
Even after testing, it may still be unclear whether preterm labor will progress to preterm delivery.
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 labor, but for 1/3 of women, preterm labor ends naturally.
However, if preterm labor does continue, your doctor will provide you with individualized instructions to protect your health and the health of your baby.
What Treatments are Available for Preterm Labor?
You may be able to reduce your risk for early labor and birth with a proper treatment plan from your health care provider. Medications may be prescribed to handle your specific case and promote a healthy birthing outcome. 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 help to increase 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 at 31 weeks or less and are at risk of delivering the baby within the next day or so, magnesium sulfate can reduce the risk of cerebral palsy, which is a common complication of preterm birth.
These drugs 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. If this is the case, you should expect the highest standard of care from a specialized team of maternity experts, including a neonatologist. Your baby may spend time in the Neonatal Intensive Care Unit (NICU) until she is strong enough to survive on her own.