Preterm Labor

The typical duration of a human pregnancy is approximately 40 weeks, or 9 months, commencing from the final menstrual period before delivery. Any labour beginning before week 37 is referred to as preterm labour (or premature labour), and birth occurring before this point is known as preterm birth. Unfortunately, preterm birth is the primary source of infant mortality and can cause long-term disabilities linked to the nervous system in children.

Risk Factors

The potential for preterm labour and premature birth can be influenced by various risk factors, some of which remain unknown to researchers. While some of these factors can be altered to decrease the risk, others cannot be changed.

The following factors are considered for putting women in the high-risk category:

1. If you have had a preterm delivery in the past or have had preterm labour before, you are considered to be in a high-risk category for having preterm labour and giving birth prematurely.
2. If you are pregnant with multiple gestations or have used assisted reproductive technology, you are at higher risk of preterm labour and birth. According to one study, the rate of preterm births was over 50% for twins, but only 10% for single births.
3. If you have certain irregularities of the reproductive organs, you may be more likely to experience preterm labour and birth than those who do not have these abnormalities. For example, women with a shortened cervix (the lower portion of the uterus) that shortens during the second trimester (from the fourth to the sixth month of pregnancy) instead of the third trimester might be at a higher risk of preterm delivery.
4. Certain racial and ethnic groups are more prone to preterm labour and birth. For example, African American mothers are more likely to have preterm infants when compared to white mothers. Additionally, American Indian/Alaska Native mothers are more likely to experience preterm labour than those white mothers.
5. Age of Mother:
   • Young females under the age of 18 have a higher risk of delivering prematurely compared to those aged 18 and up.
   • Women over the age of 35 are more likely to experience preterm birth due to medical conditions that can lead to complications necessitating delivery before full-term. These conditions may include hypertension and diabetes.

Symptoms of Preterm Labor

The most common symptoms include:

1. Contractions of the abdominal muscles sometimes referred to as birth pains, occur every 10 minutes or more frequently.
2. Alterations in the amount of fluid or bleeding that exits the vagina.
3. A sensation of stress in the pelvic region.
4. Cramps have similar sensations to those experienced during menstruation.
5. A person may experience abdominal pain along with or without diarrhoea.

Pregnant women may experience occasional contractions throughout the day, however, it is not typical to have six or more tightenings in a single hour. This could potentially be a sign that the cervix is starting to open.

Treatment for preterm labour

The cause of premature labour or birth is frequently unknown, which limits the treatments available. Nevertheless, there are a few methods that can be utilized to attempt to prevent preterm labour or birth, which are detailed below.

1. Hormone treatment: It was believed that progesterone, a hormone produced by the body during pregnancy, had the potential to stop preterm birth in those who are more likely to experience it, such as mothers who had previously given birth prematurely. The Maternal-Fetal Medicine Units Network of the NICHD discovered that progesterone administered to women who are in danger of giving birth prematurely due to a prior preterm birth can decrease the likelihood of a repeat preterm birth by one-third if given between 16 and 37 weeks of gestation.
2. Cerclage: A technique called cervical cerclage may be used to try and stop premature labour in women who have a weakened cervix and have experienced an early loss of pregnancy accompanied by a painless dilation of the cervix (the lower part of the uterus). This procedure involves the doctor suturing the cervix to close it, and the suture is removed near the woman's due date.
3. Bed rest: It has been found that bed rest is not an effective measure in preventing preterm birth, and in some cases, it may even increase the risk of early labour.

You need to have thorough conversations with the medical team to ensure you understand all of the potential risks and advantages of their treatment options. If it can be arranged, these discussions should take place during routine prenatal appointments to allow you to go over all relevant matters.

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