Signs of preterm labor

Preterm labor poses a threat to the baby’s life and health; though, it could be prevented, if you know about its symptoms.

The rate of preterm labor cases in Ukraine is reported to be around 7%.

The labors on the 49th week are believed to be the norm but usually, they occur a few weeks before or after this term. Preterm labor is the labor that started significantly earlier than 40th week, in particular, in the period from 22-37th week. Thanks to modern medical developments, doctors can preserve the life and health of the baby that is being born in such circumstances.

Preterm labor is one of the major death causes among newborns and child mortality. It could be logically explained, for the organs and systems in children born preterm are not fully developed, and it may cause the risk of acquiring disability for such a child.

The causes of preterm labor

Preterm labor could be caused by a number of reasons, including:

• fetal condition, in particular, possible development abnormalities and defects;
• mother’s lifestyle - bad habits, physical loads, regular stress, unbalanced nutrition significantly increase the risk of preterm labor;
• pregnancy course - such causes include the cases when the mother’s body attacks the fetus;
• complications during pregnancy - pregnancy with multiples, polyhydramnios, placenta previa, preeclampsia, premature placental abruption, malposition of the fetus.

If a woman presents any of the upper mentioned causes and a doctor recommends hospitalization, it doesn’t worth procrastinating with it.

In an inpatient department, the doctors will identify the cause for sure and start taking measures to preserve the pregnancy. They will determine the stage of the condition, fetal size and position.

If the doctor doesn’t find any contradictions to keeping the pregnancy, a set of measures should be taken to ensure that the pregnancy will last for 36 weeks. The following measures could be taken:

• reduction of uterine activity by pharmaceutical and non-pharmaceutical methods;
• treatment of the condition that causes preterm labor;
• enhancing the development of the fetal development and its activity;
• prescription of antispasmodics and sedatives.

If woman’s condition is critical and she is on 34th week of pregnancy, doctors usually decide on allowing labor.
Pathophysiological causes of preterm labor include the following components:

• Placental abruption (decidual bleeding);
• Excessive uterine distension or cervical insufficiency - mechanical causes;
• Hormonal disorders that can also be caused by stress;
• Reproductive tract infections.

Peculiarities of children born preterm

The children born preterm are characterized by insufficient development of the central nervous system (CNS), thermoregulation, respiratory, digestive, circulatory, immune systems. The reason is that the pregnancy never reached the stage when a sort of training of these organ systems occur. These systems ensure that the child is ready to function in the new environment after leaving its mother’s body.

The babies born preterm are particularly vulnerable and require highly technological intensive care. Preterm birth of an infant is a huge stress for parents as well, and they may need professional psychological support.

Inpatient facilities provide such children with the following types of care: comfortable environment temperature, prevention of breathing disorders, prevention of sleep disorders, timely diagnostics of the disorders or the central nervous system, respiratory system, cardiovascular system, hearing and vision disorders, infections.

Another important aspect of the care provided to preterm born infants is the early start of breastfeeding.

In inpatient facilities, the children stay in special incubators that ensure that the environment is as similar to the mother’s womb as it is possible. They preserve the necessary temperature and humidity.

The child is also supported by special devices that ensure the admission of nutrients intravenously, as well as devices that monitor the heart rate, blood oxygenation and blood pressure.

The difference between false labor and preterm labor

False labor (the scientifical name is Braxton Hicks contractions) is sporadic false contractions that may occur as the woman is approaching her due time, after 37th week of pregnancy. This type of contractions is named after the English doctor John Braxton Hicks, who was the first to describe them in his scientific work in 1872.

False labor does not pose any risk to pregnancy, they are not a sign of miscarriage or uterine opening and their intensity doesn’t increase. Such contractions are physiologically provided by nature, and their purpose is to prepare the uterus for real childbirth. The uterus becomes toned, but it doesn’t last long.

Such contractions on the early pregnancy terms are not normal, and they may pose the risk of preterm birth.

Normally, the uterus may get toned due to physical activity, active lifestyle, when the body position changes, but it doesn’t last long, and it should not happen too often.

That is why Braxton Hicks contractions on early stages of pregnancy is undoubtfully a reason to visit a doctor.

Also, there is a number of signs that false contractions turn into preterm or real labor, and it is necessary to turn to the doctor immediately, if there are any:

• Bloody discharge;
• Low back pain;
• Watery discharge;
• Changes in baby’s movements.

Prophylaxis and prevention of preterm labor

First and foremost, it is necessary to note that the general awareness level of the society, education of future parents and improvement of the skills and knowledge of healthcare professionals play a key role in the prevention of preterm labor. Social protection for women and various public programs may decrease the risk of preterm labor. It is known that women who work much or work in standing position have an increased risk for preterm labor. The women whose body weight index is below the norm (<18) or over the norm (>25) need to normalize their weight to prevent complications during pregnancy.

Before planning a pregnancy, it is necessary to give up on all bad habits, including smoking. To prevent the preterm birth, doctors also recommend keeping 2-year long intervals between pregnancies to allow the woman’s body to recover.

Also, doctors do not recommend surgical treatment of cervical dysplasia during pregnancy without significant indications.
Before planning a pregnancy, it is worth undergoing a complex body examination, including the thyroid gland hormone test and ultrasound examination. Thyroid gland disorders may interfere with the normal course of pregnancy and cause preterm placental abruption and preterm labor.

Also, before conception, both partners should be tested for sexually transmitted infections: chlamydia, syphilis, HIV, viral hepatitis, cytomegalovirus, toxoplasmosis, etc. If a woman has no immunity against rubella, doctors may recommend vaccination.

Folic acid plays a key role in preparing the body to conceive a child. Its deficiency may cause the risk of preterm labor. What is more, doctors say that folic acid prevents fetal neural tube defects. Of course, before taking additional vitamins and microelements, it is worth consulting a doctor and taking the necessary tests.

Screening for vaginosis, candidiasis and other infections during pregnancy can prevent the risk of premature birth.

The main rules of pregnancy planning are as follows:

• pregnancy should be planned for the the age of 19-35 years;
• no bad habits;
• adequate body weight;
• healthy lifestyle;
• detection and treatment of sexually transmitted diseases;
• examination of thyroid gland;
• intervals between pregnancies;
• use of necessary vitamins and microelements according to the doctor`s recommendations (folic acid, Omega-3, etc.);
• regular gynecological examination (including examination of the cervix, collection of the necessary swabs, cytology);
• detection and treatment of dental conditions;
• sufficient nutrition, consumption of food rich with proteins and iron.

Psychological support to parturient woman

Psychological support of relatives and medical staff is extremely important both during normal and premature births.

Healthcare professionals should explain all the manipulations and procedures and why they are performed. The positive atmosphere and the respect to woman’s wishes are also important. It is necessary to ensure the proper hygienic condition of the woman and her partner (in case of partner labor), as well as of the premise and healthcare personnel.

At woman’s consent, the healthcare personnel should ensure parturient woman’s movement and encourage her to move on her own. Specialists` tips on choosing a position, calming down, reducing pain with appropriate massage methods, special breathing techniques will also be useful.

Signs of preterm labor

The main signs of preterm labor include the following:

• Amniotic fluid leakage;
• Regular and frequent uterine contractions;
• Stomach ache;
• Changes in discharges and their color;
• Low back pain, pressure on the genitals, etc.

It is extremely necessary to monitor your condition, pay attention to your condition and do not violate the doctors’ advice. If a woman is aware that she is under increased risk of preterm labor, it is necessary to avoid any excessive physical activity, rest more, maintain a healthy weight and good-quality sleep. If there were cases of premature labor in family history, it is necessary to pay more attention to this issue.