Preterm Labor: Symptoms, Risk Factors and Diagnosis

Preterm labor happens when your cervix begins to open as a result of frequent contractions after week 20 and before week 37 of pregnancy.

Premature birth can arise from preterm labour. The hazards to your baby's health increase with the timing of the early birth. The neonatal intensive care unit (NICU) must provide specialised treatment for many premature babies (preemies). Long-term physical and mental impairments are also possible in preemies.

Preterm labour frequently has an underlying reason that is unclear. Preterm labour can happen in pregnant women without any known risk factors, but it can also happen with certain risk factors.

The disorder is more frequent in girls, but it can also happen in males as a side effect of hypospadias or other conditions.

Read this blog further to get a quick overview of this important topic for obstetrics and gynecology and ace your NEET PG exam preparation.

Symptoms Of Preterm Labor

Preterm labour symptoms and signs include:

• Abdominal tightening (contractions) that occur frequently or on a regular basis
• Persistent low, dull back pain
• The feeling of lower abdominal or pelvic pressure
• Mild stomach pain
• Light bleeding or vaginal spotting
• Preterm rupture of membranes is when the membrane surrounding the infant tears or breaches, resulting in a gush or a steady drip of fluid.
• A variation in the type of vaginal discharge, such as bloody, mucus-like, or watery

Risk Factors For Preterm Labor

Any pregnancy can experience preterm labour. However, a number of factors, including the following, have been linked to an increased risk of premature labour.

• Prior early birth or preterm labour, especially during the most recent pregnancy or during more than one prior pregnancy
• Twin, triplet, or other numerous pregnancies
• Reduced cervix
• Issues with the placenta or uterus
• Taking illicit drugs or smoking cigarettes
• Several infections, especially those of the lower genital tract and amniotic fluid
• Several long-term diseases, including diabetes, autoimmune disease, depression, and high blood pressure
• Stressful life circumstances, including losing a loved one
• Polyhydramnios, or an excess of amniotic fluid
• Bleeding from the vagina during pregnancy
• Foetal birth defect present
• A gap between pregnancies of less than 12 months or more than 59 months
• Preterm labour may not be something you can stop, but there are many things you can do to encourage a healthy, full-term pregnancy.

Diagnosis For Preterm Labor

The following tests and techniques can be used to identify premature labour:

• Examination of the pelvis. Your doctor may assess the size and positioning of the baby as well as the firmness and soreness of your uterus. He or she may also perform a pelvic exam to see if your cervix has started to open if your water hasn't burst and there are no concerns that the placenta is covering the cervix (placenta previa). Additionally, your doctor might look for uterine haemorrhage.
• Ultrasound. Your cervix's length might be measured with a transvaginal ultrasound. An ultrasound may also be used to determine the baby's weight, confirm the baby's position, determine the amount of amniotic fluid present, and check for any issues with the baby or placenta.
• Uterine surveillance. To gauge the length and spacing of your contractions, your doctor may use a uterine monitor.
• Tests in the lab. Your doctor may take a swab of your vaginal secretions to screen for the presence of specific infections and foetal fibronectin, which is released during labor and functions as a glue between the foetal sac and the lining of the uterus. These findings will be examined alongside additional risk factors. Additionally, you'll give urine sample to look out for certain bacteria.

Treatment For Preterm Labor

Treatment Medications

There are no drugs or surgical techniques that can permanently halt labour once it has begun. However, your physician might suggest one of the following drugs:

• Corticosteroids- Corticosteroids can support the development of your baby's lungs. If you are believed to be at a higher risk of delivery within the next one to seven days and are between 23 and 34 weeks pregnant, your doctor will probably advise corticosteroids. If you run the danger of giving birth between 34 and 37 weeks, your doctor might also advise steroids.

If you are less than 34 weeks pregnant, at risk of giving birth within seven days, and you previously received corticosteroids more than 14 days ago, you can be prescribed a repeat course of the medication.

• Magnesium sulphate- In the event that you are at a high risk of giving birth between weeks 24 and 32 of your pregnancy, your doctor may recommend magnesium sulphate. Babies born before 32 weeks of gestation may have a lower risk of developing a certain type of brain injury, such as cerebral palsy, according to some studies.

• Tocolytics- To temporarily stop your contractions, your doctor may give you a drug called a tocolytic. Tocolytics may be administered for up to 48 hours to postpone preterm labour so that corticosteroids can work to their full potential or, if required, so that you can be evacuated to a hospital that can give your tiny infant the specialised care he or she needs.

Tocolytics generally have not been found to enhance the outcomes of babies because they don't target the fundamental cause of preterm labour. If you have specific disorders, such as pregnancy-induced high blood pressure (preeclampsia), your doctor won't advise you to use a tocolytic.

If you're not hospitalised, your doctor may need to plan weekly or more regular appointments so they can keep an eye out for preterm labour signs and symptoms.

Surgical Techniques

Your doctor might advise cervical cerclage surgery if you are in danger of preterm labour due to a short cervix. Strong sutures are used to sew the cervix shut during this surgery. Usually, the sutures are taken out 36 whole weeks into the pregnancy. The sutures may be taken out if required.

Prevention For Preterm Labor

• Look for routine prenatal treatment. Your doctor can keep an eye on both your and your unborn child's health with the help of prenatal checkups. Mention any symptoms or indicators that worry you. You might need to visit your doctor more frequently throughout pregnancy if you have a history of premature labour or exhibit preterm labour signs or symptoms.
• Adopt a balanced diet. Nutritionally sound eating habits are typically linked to healthy pregnancy outcomes. A diet rich in polyunsaturated fatty acids (PUFAs) may also reduce the incidence of premature birth, according to certain studies. Nuts, seeds, fish, and seed oils contain PUFAs.
• Avoid dangerous chemicals.
• 1 1 Quit smoking if you do. Inquire about a smoking cessation programme with your doctor. Also prohibited are illicit drugs.
• Think of separating pregnancies. Premature births are thought to be more likely to occur when pregnancies are spaced fewer than six months apart or more than 59 months apart, according to some studies. Consider discussing the spacing of pregnancies with your doctor.
• When utilising assisted reproductive technology (ART), use caution. Think about the number of embryos that will be transplanted if you intend to use ART to conceive. The likelihood of premature labour is greater with several pregnancies.
• Organise chronic illnesses. Preterm labour is more likely in people who have certain diseases such as diabetes, hypertension, and obesity. Work with your doctor to manage any chronic diseases you may have.

Also Read: Vaginal Yeast Infections

Complications Of Preterm Labor

Delivering a preterm baby is one of the preterm labour complications. Your kid may experience a variety of health issues as a result, including low birth weight, breathing issues, undeveloped organs, and eyesight issues. Premature birth increases a child's chance for cerebral palsy, learning impairments, and behavioural issues.

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