Premature (or Preterm) Labour

What is it?

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Pregnancy normally lasts between 37 and 42 weeks (term pregnancy). Premature (or preterm) labour occurs before the 37th week of pregnancy. Sometimes labour may be started early by a doctor for the safety of the mother and/or baby. But when premature labour occurs unplanned, it is called spontaneous premature (or preterm) labour.

Spontaneous preterm labour is sometimes linked to a specific cause, such as early ‘breaking of waters’, i.e. early rupture of membrane. But most times, the cause of preterm labour is not known. There are however, certain things that can increase the likelihood of having a preterm labour. But having them still doesn’t mean a preterm labour will definitely occur. They include:

  • Previous preterm labour
  • Multiple pregnancy (twins and tripleys)
  • Smoking during pregnancy
  • Infections like pelvic inflammatory disease
  • Previous surgeris on the neck of the womb (cervix)
  • A short cervix
  • Previous abortion(s)

It is important to know that about half of all preterm births occur without the presence of any of these risk factors.

What are the symptoms?

Pointers to labour include:

  • Vaginal bleeding
  • Cramps (contractions)
  • A new onset lower back pain
  • Pressure
  • Fluid leakage from the vagina.

Once these symptoms are noticed, it is important to get to a hospital as soon as possible to avoid complications. The doctor will have to confirm the onset of true labour and then manage appropriately.

What treatments work?

There are some examinations and tests the doctor performs if they feel a woman may go into labour early. However, it is usually difficult to predict whether a woman will have a premature labour, or stop it from happening. But there are treatments which may help prevent an early labour in women at a high risk.

If a woman has a short cervix, the doctor may have to stitch around her cervix to help stop her it from opening too early. Antibiotics can probably help take care of the infections that may cause preterm labour.

Once labour starts, it may not be able to be stopped, but you go into labour, there’s little anyone can do to stop it. But it may be delayed for a few days to enable the baby grow, and allow enough time to seek specialist help.

Some injections may also be given before delivery to protect the premature baby by speeding up its development. They work best if given at least 24 hours before delivery.

What will happen to my baby?

Babies born before 23 weeks usually do not survive.

Babies born after 32 weeks generally do well. They may start off weaker and have to stay in hospital a little longer than normal. But in the long run they usually do as well as other babies carried to term.

Babies whose birth fall in between these times may be very small and not properly developed, and may need special care in an incubator. Some need a life-support machine to help them breathe.

By and large, the outlook for babies born prematurely is steadily improving over time.