Definition and Description:-
Starting of labour before the term between 20th to 37th week of pregnancy is known as preterm labour.
The contraction of uterus and dilation of cervix to give birth to child is called Labour. Early starting of labour before the completion of gestational age is called as Preterm Labour.
Preterm Labour is one of the challenging complications in the obstetrics. The cause of 75% of neonatal deaths is Preterm Labour. Nearly 1 out of 10 deliveries is preterm labour in the united states. Even though the exact cause of preterm labour is not known, by reducing the risk or predisposing factors the rate of preterm labour can be controlled.
Risks of preterm labour:-
- Due to Early delivery, the fetus is not completely developed and the chances of neonatal deaths are high.
- Preterm labour baby after 32th week may sustain as the death risk is reduced.
- In earlier deliveries before the 24 th week, the survival chance of the neonate is very low.
- The survived preterm babies may have, long term health problems.
- Preterm babies may have reduced growth, less intelligence, etc.
- Mothers may get emotionally upset.
Causes of Preterm Labour:-
The exact cause of preterm labour is not known, but the problem with baby or mother or both may cause preterm labour. Most of the preterm labours are natural and some are caused by the use of medicines and are said to be medically induced.
- Placenta abruptio : placenta separates from uterus earlier.
- Pre eclampsia : increased blood pressure or hypertension during pregnancy.
- low social economic status of mother,
- previous history of second trimester abortion,
- Previous history of preterm labour,
- Infection of the mother’s uterus leads to contraction of uterus and causes preterm labour.
- Multiple pregnancy : having more than one fetus in the womb.
- Uterus diseases, or cervix disorders.
- Bursting of amniotic sac before contraction of labour,
- Alcohol or smoking by the mother during pregnancy.
Symptoms of Preterm Labour:-
It is difficult to suspect the preterm labour as it starts earlier. The nature of contractions will be as follows.
- Contraction of uterus, more than 8 times, per hour. The belly becomes firm due to uterus contractions.
- Pink or reddish fluid discharges from the genital organ, may leak or gush out.
- Pain similar to menstrual cramps, may be with or with out diarrhoea.
- Increased pressure in the pelvic region or lower belly.
- Premature rupture of membranes,
- Dull lower back pain, pain in the thighs, lower abdominal discomfort, etc.
- discomfort, weakness, fever may be present.
- Braxon hicks contractions are the painless small contractions which are normal. Careful assessment should be done to identify preterm labour pain.
Diagnosis of preterm labour:-
* The thorough physical examination helps in diagnosing preterm labour. Dilation of the cervix, rupture of membranes, presence of any infections are found during physical examination.
* Urine blood tests to identify infection and other significant results.
* Ultrasound scan, fetal heart rate gives the activities of babies in the womb.
* Amniotic fluid is tested to identify infection.
Treatment of preterm labour:-
* Medications are given to postpone the suspected preterm labour, but it is not the effective method.
* Antibiotics are used to treat infections of the uterus, and an infection caused by the amniotic fluid.
* Steroids are administered to increase the survival rate of the baby.
* Treat associated problems with pregnancy,
* Don’t try to avoid labour if the uterus contractions are severe and cervix has dilated, as the delay may harm the mother’s health.
* Tocolytic therapy is also given to treat preterm labour.
* Magnesium sulfate and other drugs are used.