Preterm labor is one of the leading causes of perinatal death. A premature baby has only a few percent chance of survival. Even if he is born, he may develop complications early or late in terms of physical and psychological development. What are the causes of preterm labor? How to recognize its symptoms? Can preterm labor be prevented?

Premature labormarks the end of pregnancy between the 23rd and 37th week of pregnancy (counting from the first day of the last menstruation). Some people consider thepreterm labor criteriato consider the child's weight (minimum 500 g, but not more than 2500 g) and body length (measured from the top of the skull to the heel - at least 25 cm) however, in some cases these values ​​can be misleading and therefore only the time of termination of pregnancy is usually considered.

Preterm labor - causes and risk factors

Research shows that the number of premature births has increased in recent years. According to specialists, it is directly related to the increasing age of future mothers. Diseases can emerge over the years that can create problems during pregnancy and lead to premature termination. These include :

  • diabetes
  • hypertension
  • uterine fibroids

These and other diseases can also contribute to problems with getting pregnant. This makes fertilization support methods (including IVF) more and more popular, which often result in multiple pregnancies. And this one is one of the stronger risk factors for preterm labor. In addition, they can also contribute to it:

  • some bearing defects (leading bearing)
  • anatomy of the uterus
  • cervical failure
  • previous premature births
  • stillbirth or spontaneous miscarriage
  • pregnancy interval less than 6 months
  • premature rupture of the fetal bladder
  • various types of infections, not only of the genitourinary tract, but also of the respiratory tract
  • sexually transmitted diseases

The lifestyle of a pregnant woman is also important. Bad nutrition, stimulants (smoking, drinking alcohol), stressful lifestyle,physical work also increases the risk of preterm labor.

It should be noted that preterm labor is a multifactorial phenomenon. For this reason, it is not possible to distinguish only one mechanism responsible for its occurrence.

Preterm labor - how to recognize the symptoms of preterm labor?

The first symptoms of preterm laborthat should prompt a pregnant woman to see a doctor as soon as possible are all kinds of bleeding and discharge. The contractions, even the slight ones, which may be felt as painful ailments in the lumbar region, should also cause anxiety. If you experience a burning or stinging sensation when urinating, it could be a sign of an infection, usually the genitourinary tract, which is common during pregnancy.

Depending on the advancement of labor, there are three types of preterm labor:

1. Threatening premature labor, i.e. the early stage of labor:

  • 4-7 uterine contractions per minute;
  • cervical opening less than 3 cm;
  • shortening of the cervix below 60%

This is a reversible phase of labor, i.e. the doctor can stop the premature contractions of the uterus so that the baby remains in the womb for as long as possible.

2. Preterm labor in progress:

  • contractions frequency is min. 8 per minute;
  • dilation of the cervix at least 3 cm;
  • the cervix is ​​shortened by at least 80%;

3. Premature delivery is the end of pregnancy.

Important

Premature delivery - complications

The survival and morbidity of premature babies largely depends on the gestational age of the child. Thanks to the advancement of medicine, the birth in 34.-35. During the week of pregnancy, when steroids were administered to the baby earlier, they no longer pose a threat to him. Then the prognosis is very good. Babies born earlier (especially between the 23rd and 28th week of pregnancy) are still at risk of many complications:

  • low birth weight;
  • respiratory failure due to insufficient development of the lungs;
  • retinopathy of premature babies;
  • neurological disorders;
  • developmental disorders;
  • poor liver function;

Premature delivery - management

If there is a risk that preterm labor may occur, the pregnant woman should rest, lie in bed frequently and avoid excessive physical exertion and stress. If your doctor has diagnosed cervical failure, he or she may recommend a maternity pessary. It is a puckring-shaped that is inserted into the vagina. Another option is to place a suture around the cervix. It is assumed from 18-20. week of pregnancy. With this type of surgery, it is necessary to exclude the threat of premature delivery. Uterine contractions and genital tract infections are also contraindications for the suture.

Ifthreatening premature birthis diagnosed, the pregnant woman should go to the pregnancy pathology ward in a specialized hospital with experienced medical personnel and appropriate equipment (incubators, ventilators, vital signs, infusion pumps). The goal of doctors is to prevent preterm labor, which is why they administer to the patient drugs that inhibit uterine contractions. Usually these are tocolytic drugs that are used in women with cervical lesions. However, they cannot be given if the mother has heart disease, has diabetes, has high blood pressure, or has had infections. The pregnant woman is also given corticosteroids - drugs that accelerate the development of the fetal lungs.

If treatment is unsuccessful, preterm labor is most often (but not always) performed by caesarean section as it is the least burdensome for the baby. In addition, premature babies are more often positioned in the pelvis (buttock), which is also an indication for a caesarean section.

Premature birth - prevention

  • have regular check-ups. They should take place every 3-4 weeks, and at the end of pregnancy - more often. Bacteriological control of the vagina is especially important;
  • do not underestimate any ailments - tell the doctor about all of them;
  • reduce work and effort, give up stimulants, lead a calm, stress-free lifestyle;

Category:

Pregnancy