Preterm Labour – Causes, Signs, and Treatment

For many women, pregnancy lasts for about 40 weeks or so, but for some, it may end early. When women go into labour more than three weeks before the due date, it is termed preterm or premature labour. Read on to know about preterm labour – what causes it, what to do when you are in premature labour, how to prevent it, and more!

Video : Reasons for Preterm Labour and How It Affects the Pregnancy

What is Premature Labour?

Most pregnancies last full-term, and babies are usually born between 39 and 40 weeks of pregnancy. However, in certain cases, there are chances of the labour beginning a lot earlier than the completion of the time period. Such premature labour usually happens prior to completing 37 weeks of pregnancy. The contractions of the uterus trigger the cervix to prepare for labour and it begins to open up. This may lead to the baby being born prematurely, which has its own set of challenges and health-related issues.

What Causes Preterm Labour?

Here are some of the causes of preterm labour.

1. Multiple Babies

If a woman is pregnant with twins or triplets (and in rare cases even more than that), in such a case, the chances of premature labour are higher, since there is quite a lot of pressure on the uterus and the cervix.

2. Vaginal Infections

Certain women suffer from a bunch of infections during pregnancy such as urinary tract infection, kidney infections, vaginal infections and so on. A few women might suffer from sexually transmitted diseases (STDs), too. These infections may increase the chances of preterm labour.

3. High Fever During Pregnancy

If the pregnant woman is suffering from illnesses and diseases, which lead to a fever that is more than 101 degrees, the woman may go into labour earlier than full-term.

4. Vaginal Bleeding

Sometimes, vaginal bleeding may be the reason for preterm labour. Such kind of bleeding is usually observed post 20 weeks of being pregnant.

5. Pre-Existing Health Issues

Some women suffer from chronic health problems before pregnancy, which might only worsen during pregnancy. Diabetes, kidney problems, high blood pressure and similar health issues may put undue stress on the body and may result in preterm labour.

6. Previous Abortions

If the woman has had more than one abortion prior to the current pregnancy, most of which could be in the first trimester, or even a couple of them in the second trimester, then the risk of preterm labour taking place is higher in such cases. The uterus loses its strength in being able to hold the baby to full growth and might trigger labour.

7. Weight Issues

Having improper weight always leads to problems during pregnancy. Being overweight puts pressure on the body and its systems to support both the mother and the child, and being underweight can cause nutrition-related problems as well as strength and immunity issues. This, in combination, could also cause the body to force preterm labour into taking place.

8. Thrombophilia

Thrombophilia is a condition where the body is susceptible to thrombosis. The blood in the body suffers from hypercoagulability, which leads to the formation of blood clots randomly within the blood vessels themselves. This is quite a serious condition and, amongst other effects, can cause preterm labour, too.

9. In-Vitro Fertilization

If a woman, post undergoing IVF, gets pregnant with only a single foetus, it has been observed that her chances of going into preterm labour are slightly higher than usual.

10. Consecutive Quick Pregnancies

There needs to be a substantial time between two pregnancies for the body to recover and be prepared for the next one. If the consecutive time between the last birth and the current pregnancy is less than a year or so, the chances of preterm labour happening for the current pregnancy are quite high.

11. Lifestyle Choices

Various lifestyle choices directly affect the health of the baby as well as the term of pregnancy. Smoking, drinking, illegal drug use, sedentary life choices, standing for long hours, are all factors that can put pressure on the body and lead to preterm labour.

12. Stress

Mental health is a major factor that affects pregnancy. Being constantly stressed and anxious about work and family issues, or facing domestic violence or emotional abuse, and constantly high-wired situations at home could push your body towards preterm labour.

Signs and Symptoms

Preterm labour symptoms can be spotted with good observation, and acting in time can help resolve the issue.

• Lower backache, that doesn’t reduce even after changing positions.
• Contractions that are spaced out by 10 minutes or even lesser.
• Extreme cramping resembling menstrual cramps in the lower section of the abdomen. These could be similar to gas trouble and may also result in loose motions.
• Unexpected leaking of fluid from the vagina.
• Most major symptoms of a typical onset of flu. Feeling of nausea, vomiting, diarrhoea, and the body’s refusal to consume liquids.
• A build-up of pressure on the vagina as well as the pelvic region.
• Increased and speedy discharge in the vaginal tract.
• Light coloured bleeding from the vagina.

What Do Contractions Feel Like?

False contractions during pregnancy are called Braxton-Hicks contractions. This is where the uterine muscles begin to contract within, hardening the abdomen. When the contractions subside, the muscles become soft again. These contractions are mostly irregular without any specific frequency, and usually, do not cause the cervix to open.

However, the moment these contractions become frequent and can be nailed down to a frequency of happening between 10 to 12 minutes for quite some time, these could indicate preterm labour and the doctor can check if the cervix has opened up.

How to Check for Contractions

• Hold your fingertips over the abdominal area of the body.
• Check if you can feel the contracting and loosening of the uterine muscles.
• Note down the times when each contraction takes place and how long they last.
• Attempt to stop the contractions by changing your position, relaxing, and drinking some water.
• If the contractions continue for an hour with the same frequency, or the conditions worsen and severe pain starts setting, it’s time to consult a doctor.

What to Do If You Are Experiencing Premature Labour

Here’s what you should be doing in case you are experiencing premature labour.

• The first thing you can do is pee and empty your bladder fully.
• You can lie down on your bed and turn to your left side. This will help slow down the contractions, which may also stop them completely.

• Do not lie on your back. This is a standard position to accelerate the contractions.
• Sometimes, lack of water and dehydration can result in contractions, too. So drink multiple glasses of water until you’re full.
• Keep a track of your contractions and check if they remain constant or if they’re slowing down.

Diagnosis and Tests for Premature Labour

Some of the tests to diagnose premature labour are,

1. Examination of the Pelvis

The doctor might choose to check the uterus and examine it to see if it is firm and tender, while simultaneously understanding the baby’s position and size. Once the doctor is assured that the water has not broken and that the placenta is not covering the cervix, the doctor might further examine the cervix to check if it has started opening.

2. Ultrasound Monitoring

The doctor might want to check the length of the cervix and, hence, choose to conduct a transvaginal ultrasound. The ultrasound helps obtain a better understanding of the position of the baby and the amount of fluid inside, and make an assessment of weight.

3. Observing the Uterus

In case you are having contractions, the doctor might want to get more information related to them, with a uterine monitor. This device helps assess and calculate the length of your contractions as well as the frequency between them.

4. Specific Laboratory Tests

The doctor will go ahead and use a cotton swab to take a sample of vaginal secretions for checking infections. This also helps check for signs of fetal fibronectin, that functions as a strong glue, bonding the uterus lining with the fetal sac. A urine sample will also be collected to check for any bacterial or viral presence.

Treatment to Prevent Preterm Labour

No medicines or surgeries can prevent labour from happening once it has begun. There are certain recommendations that your doctor might ask you to consider.

Medications

Depending on what stage of pregnancy the preterm labour conditions might occur in, your doctor may suggest the use of corticosteroids to speed up the lung growth of the baby. These are mostly recommended if the pregnancy is between 24 weeks and 34 weeks. In the final stages, if your delivery is imminent within 34 weeks and 36 weeks of pregnancy and you haven’t had a dosage of corticosteroids previously, then your doctor might ask you to have them.

In certain cases, magnesium sulfate is also recommended by the doctor. If a baby is born before 32 weeks of pregnancy, there are chances of incomplete brain growth. Administering magnesium sulfate reduces the risk of this from happening, leading to avoiding conditions such as cerebral palsy.

The final frontier that can be taken in cases of preterm labour is delaying it temporarily. Tocolytics are a specific kind of medication that help stop the contractions for a small period of time. These mostly last only as long as two days. However, this time might be utilized by the doctors to allow the corticosteroids in accelerating the baby growth as much as possible or shifting you to another hospital where facilities to support premature babies are available. Pregnant women suffering from high blood pressure are not recommended to take tocolytics.

Surgery

In very specific cases, the doctor might recommend you to undergo cervical cerclage, a surgical procedure. This is primarily beneficial to women who have a short cervix. This procedure is mostly recommended only if your pregnancy is below 24 weeks, your previous pregnancies have resulted in premature deliveries, and your cervix length is less than 25mm in length, as revealed from an ultrasound.

In this procedure, the cervix is closed by using strong sutures and stitching it shut. As you complete 36 weeks of your pregnancy, the sutures are removed so that natural labour may take place.

What Can You Do to Prevent Premature Labour?

Here are some precautionary measures to prevent preterm labour.

1. Prenatal Care

Prenatal care helps address any medical conditions and take a check of medicines you are on to ensure that you and your baby stay safe during pregnancy.

2. Influenza Shot

Suffering from flu during pregnancy increases your chances of preterm labour. Hence, it is best to get a flu shot as an active preventive measure.

3. Quit Smoking

If you smoke, it’s time to quit it. Opt for nicotine patches, although not ideal, or other ways to wean away from cigarettes.

4. Manage Your Weight

Obesity is a strong cause to trigger preterm labour. Maintain a healthy balanced diet and continue with light exercises and movements as much as you can.

What Impact Does Premature Labour Have on Pregnancy?

A full-term pregnancy can increase the chances of having a healthy full-grown baby. Premature labour does not always mean that delivery will be premature. In case it does happen, such babies are at risk from physical and mental health complications now and later in life. Babies born in less than 24 weeks of pregnancy have a 50-50 chance of survival.

Preterm labour management is absolutely necessary to ensure mitigating chances of premature delivery, without causing harm to the child. By taking preventive measures at the start and opting for treatments if recommended, the chances of premature delivery can be reduced and both the baby and mother can be safe.

Also Read: Best Ways to Avoid Premature Labour