What is preterm labor? Preterm labor occurs when a mother begins to have frequent contractions in which the cervix begins to open and close in preparation for delivery1. When this occurs after the 20th week and before the 37th week of pregnancy, it is referred to as preterm labor. Preterm labor can lead to preterm birth, which can lead to birth defects, undeveloped organs, breathing problems, and death depending on how early the child is delivered. If you suspect you are going into preterm labor, contact your health provider immediately or schedule an appointment to see one of our obstetricians in Manhattan today. You should not wait, book the earliest possible appointment as some preterm labor cases can be stopped with proper treatment.
How do you know if you are at risk of preterm labor?
No one knows for certain why preterm labor occurs, but there are certain risk factors that increases a woman’s odds of going into labor early. Below is a list of risk factors associated with preterm labor.
Short Cervix: Women whose cervix shorten early on during pregnancy are at a greater risk of going into preterm labor. As the due date approaches, the length of pregnant woman’s cervix usually begins to shorten, the early on-set on this hints at a possibility of preterm labor and possibly preterm birth. Precautions can be taken to prevent this and in severe cases the woman is placed on bedrest.
Recurring kidney/bladder infections: It has been observed that women who suffer from multiple kidney/bladder infections during pregnancy are at a higher risk of going to preterm labor2.
Previous preterm birth: It has been noticed that women with a history of preterm birth are at a higher risk of going into preterm labor.
Short interval between pregnancies: The body needs time to heal and repair itself after childbirth. The shorter the amount of time between pregnancies, the higher the chances of going into preterm labor. It is recommended that you wait 1-2 years between pregnancies.
Surgeries on the cervix and uterus: Certain types of surgeries on the uterus and cervix may put a woman at greater risk of going into preterm labor.
A multiples pregnancy: Women who are pregnant for multiples are at a much greater risk of preterm labor as there is less room for the babies to grow in utero. As such a pregnancy that reaches 36 weeks is considered successful and will most likely not need a premature infant specialist.
Preeclampsia: High blood pressure during pregnancy is also a significant indicator.
Stress/Long working hours: Women who work long hours, especially those that are required to stand are at a higher risk of preterm labor. Women in labor are usually encouraged to walk around to speed things up. There is a reason for this, Gravity. Constantly standing when you are pregnant puts you at a greater risk of preterm labor as gravity does aid and can cause a woman to go into labor.
Multiple abortions: Multiple abortions in the first trimester increases a woman’s risk factors. Also one or two abortions in the second trimester will also greatly increase your changes of preterm labor.
Premature rupture of membranes: When the amniotic sac rupture prematurely, the mother is at a very high risk of going into early labor.
Hydramnios: This is a condition in which there is too much amniotic fluid. Here, this condition can easily be treated with an amniocentesis procedure (where amniotic fluid is collected from the amniotic sac).
Placenta complications: if the positioning of the placenta is low or there is a placenta abruption (detachment from the uterus), then the chances of early labor/birth increases tremendously.
Vaginal bleeding: Vaginal bleeding that occurs after the 20th week has been observed to be an early signal and precautions are usually taken to reduce risk factors.
Lifestyle habits/factors: A woman with low pre-pregnancy weight is at a greater risk of preterm labor. Moreover lifestyle habits such as smoking and substance abuse can induce labor.
How do you know if you are in preterm labor?
Early intervention may prevent premature birth, hence it is important to know the early signs of preterm labor. Below are a few signs you should watch out for regardless of if you are at a higher risk.
- Change in vaginal discharge; have you noticed any bloody, watery or mucous discharge lately
- Constant lower backache
- Increase in the volume of vaginal discharge
- Cramps similar those of menstruation1. This may occur with or without diarrhea
- Pressure in pelvic or lower abdominal area
- Frequent contractions that occur at regular intervals/ the tightening of the uterine. This might either be painless of painful.
- Water breaks (ruptured membrane)
If you experience any of the symptoms mentioned above, you should immediately contact your health provider and go in for an examination as soon as possible.
How soon will you give birth after your preterm labor begins?
There is no way to know how soon you will give birth after preterm labor begins. However, it is important to note that only 10% of women who go into preterm labor will give birth within 7 days of going into labor. Moreover, about 30% of all preterm labor would natural resolve itself and stop on its own after a few days3. There are also steps and drugs that can be taken to prolong pregnancy. Both the mother’s and the baby’s health would have to be taken into consideration before any type of intervention is taken.
What are your options if your preterm labor does not stop?
After you begin to experience signs of labor, contact you doctor immediately. Depending on your condition, you would either be sent home on bedrest after further examination or hospitalized if you contractions do not stop and increase in frequency. There are drugs that can be used to stop labor. Regardless of the success of these drugs, steps will be taken to speed up lung development of the fetus. Below is a list of the steps that are taken to speed up development/slow down contractions:
- Tocolytic medication: This is used slow down / stop contractions for 48 hours2. This is usually given to the mother in order to give the other drugs time to speed up the development of the fetal lungs.
- Magnesium sulfate: This is usually given to mothers that are less than 32 weeks and are at risk of delivering within 24 hours. This drug is used to reduce the chances or risk of cerebral palsy that has been linked to early preterm birth3.
- Corticosteroids: This drug is used to help speed up the fetal lungs, brain and digestive development3.
- Cervical cerclage: This is a procedure to suture the cervical opening for women who have incompetent or develop short cervix during pregnancy. This keeps the cervix closed and helps prevent preterm birth/labor.
- Delivery: If labor does not stop after treatment and both the mother/ and or child goes into distress. Delivery of the baby will be allowed to occur and in some cases a cesarean will be recommended. The neonatologist (premature infant specialist) will be brought in to care for the child after birth.
Whether you at risk of preterm labor or not, you should consider early prenatal care and routine checkup as this allows your health provider to catch any influencing factors early on. For more information on preterm labor, visit us at 67th Street OB/GYN Total Women’s Health Care and special to one of our OB/GYN in Manhattan today.