• Shruti GOCHHWAL

What Are The Causes Of Preterm Labor And How To Manage It?

Preterm labor or premature labor is when your body gets ready for the birth of your baby too early than the expected due date. Learn the causes of preterm labor and know how it can be managed.

What Is Preterm Labor?

Preterm labor is defined as regular contractions of the uterus that results in changes in the cervix before 37 weeks of pregnancy. Preterm labor can result in premature birth. Premature birth can happen after week 20 and before 37 weeks of pregnancy. Premature babies may not be fully developed and may face complications including physical and learning disabilities.

The incidence of preterm labor is between 5% and 10% in developed nations. It is estimated by the World Health Organization that approximately 15 million babies are born preterm every year. Based on the gestational age, preterm birth is categorized into.

  1. Extremely preterm (less than 28 weeks)

  2. Very preterm (28 to 32 weeks)

  3. Moderate to late preterm (32 to 37 weeks).

The lower the gestational age, the higher is the risk of morbidity and mortality.

Who Is At Risk Of Preterm Labor?

Risks of preterm labor

Overweight woman, Credits: pixabay


Some of the risk factors of preterm labor are listed below.

  1. Smoking and use of illicit drugs

  2. Maternal age less than 20 or more than 35

  3. Overweight or underweight before pregnancy

  4. Any family history or personal history of preterm delivery

  5. Multiple pregnancies (twins, triplets)

  6. Shortened cervix

  7. Abnormally shaped uterus

  8. Placenta is an abnormal position

  9. Infection

  10. Chronic health conditions like high blood pressure, diabetes, and autoimmune diseases

  11. Polyhydramnios- amniotic fluid too high

  12. Vaginal bleeding during pregnancy

  13. If the pregnancy interval is less than 12 months or more than 59 months

  14. Stress

  15. Problems with fetal growth and chances of birth defects

Signs and Symptoms of Preterm Labor

The following are the signs and symptoms of preterm labor.

  1. Frequent Contractions

  2. Constant low backache

  3. A feeling of pelvic or lower abdominal pressure

  4. Mild abdominal cramps or menstrual-like cramps

  5. Vaginal spotting or light bleeding

  6. Premature rupture of membranes

  7. Changes in type and amount of vaginal discharge (Blood, mucus or watery fluid)

  8. Increased pressure in the vagina or pelvis

Seek immediate medical attention if you have the symptoms of preterm labor.

Management of Preterm Labor

The management of preterm labor involves identifying women who are at risk of undergoing preterm labor. Definite scoring and clinical tools are limited.

Investigations such as fetal fibronectin or cervical ultrasound can be used to identify women at high risk.

 Positive swab for vaginal fetal fibronectin taken in the late second or early third trimester increases the likelihood of preterm delivery.

Cervical length measurement can help identify women who are at risk of preterm labor.

Treatment of Preterm Labor

The treatment of preterm labor is as follows

Corticosteroids

Treatment of preterm labor

Medicines, Credits: pixabay


Your doctor may recommend corticosteroids to help promote the maturity of your baby’s lungs, brain, and digestive organs.  Corticosteroids are often recommended if you are likely to deliver a baby in the next seven days and if your pregnancy is between 23 and 34 weeks.

Magnesium Sulfate

If you are less than 32 weeks pregnant and if you have the chance of delivery in the next 24 hours, magnesium sulfate can be used to lower the risk of cerebral palsy.

Tocolytics

Tocolytics help to slow down the contractions. It may be used to delay preterm labor for upto 48 hours.

Cervical Cerclage

If short cervix (less than 25mm) can be the cause of your preterm labor, a surgical procedure called cervical cerclage will be performed. In this procedure, the cervix is stitched closed with strong sutures and the sutures are removed after 36 completed weeks of pregnancy.

Complications of Preterm Labor

Complications of preterm labor

Premature baby, Credits: pixabay


Preterm labor results in preterm birth. The ambiance of a mother’s womb cannot be mimicked by any specialized intensive care units. Premature babies grow slower than full-term babies. Babies born before 25 weeks have higher chances of health issues like autism, intellectual disabilities, cerebral palsy, lung problems, and vision and hearing problems.  They require specialized care in neonatal intensive care units.

Preventing Preterm Labor

Prevention of preterm labor

Healthy diet, Credits: pixabay


Preterm labor cannot be prevented. But having good prenatal care and following some lifestyle modifications can help prevent preterm labor.

  1. Have good prenatal care. Learn the symptoms of preterm labor and if you suspect you have any symptoms, seek immediate medical advice.

  2. Have a healthy diet.

  3. Quit smoking and never use illicit drugs.

  4. Always have planned pregnancies. You can discuss with your healthcare provider about pregnancy spacing.

  5. If you have high blood pressure and diabetes, keep them under control.

  6. If you plan to conceive through assisted reproductive technology, do know how many embryos are inserted as multiple embryos increase the chance of preterm labor.

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