Preterm (premature) labor is a condition that occurs when a woman's body starts preparing itself to give birth too early in a pregnancy. Normal pregnancies typically last 40 weeks. In cases of preterm labor, however, a woman begins experiencing regular contractions that prepare the cervix for labor between the 20th and 37th weeks of pregnancy.
Preterm labor often results in premature birth, which increases a child's risk of birth defects, as well as cognitive and medical issues in the future. Because of the potential of serious health problems for the child that may be associated with a preterm delivery, an attempt is made to delay preterm labor for as long as possible. Preterm labor may be a direct result of an issue with the baby, the mother or, in some cases, both. However, the exact cause of preterm labor cannot always be identified.
Symptoms of Preterm Labor
In order to properly treat preterm labor, the patient must first recognize the symptoms of the condition and report them to her doctor. During preterm labor a woman may experience the following:
- Increased pressure in the pelvic area or vagina
- Vaginal discharge or fluid leakage
- Vaginal bleeding
- Contractions occurring at intervals of 10 minutes or fewer
- Nausea or vomiting
Women may also experience back pain, especially in the lower-back area, that may be persistent or intermittent, as well as cramps that often feel similar to menstrual cramps.
Risk Factors for Preterm Labor
During pregnancy, personal and behavioral habits, such as smoking, alcohol or substance abuse, may contribute to a woman's experiencing preterm labor. Other health-related conditions, such as an an abnormally shaped uterus, or a weakened or shortened cervix, may also cause preterm labor. Other risk factors for preterm labor may include the following:
- Existing conditions (diabetes, high blood pressure, preeclampsia, blood-clotting disorders)
- Family or personal history of premature labor or preterm birth
- Being significantly underweight or overweight before pregnancy
- Lack of prenatal care
- Becoming pregnant too soon after a prior pregnancy
- Pregnancy with multiple fetuses
- Infections in either the vagina or urinary tract
- Previous surgery on the cervix or uterus
Age may also be a factor in preterm labor, especially if the mother is either younger than 16 or older than 35.
Treatment of Preterm Labor
Preterm labor is not always treatable or preventable. A pelvic examination and transvaginal ultrasound may be performed in order to determine how to treat the condition, and if labor can be delayed. Several factors are generally taken into consideration when deciding how to best manage preterm labor. For example, a patient who has a health condition such as very high blood pressure, diabetes or preeclampsia often requires her baby to be delivered promptly. When the term of the pregnancy is near its end, typically somewhere between the 34th and 37th weeks of pregnancy, the preterm labor may be allowed to proceed to a delivery.
For some patients, medication such as magnesium sulfate may be administered to slow the rate of the labor, slow or stop the contractions, and treat any infection. However, if the patient's cervix is already significantly dilated, the medication may not be effective in slowing down labor. If the contractions do not decrease in frequency and strength following the administration of the medication, the patient will likely be admitted to the labor unit of a hospital for delivery. The mother may also be given corticosteroids if she is between 24 and 34 weeks of pregnancy; corticosteroids can help increase the rate of development in the lungs, brain and digestive tract of the baby prior to delivery.
Effects of Preterm Labor on the Infant
Preterm labor can affect a baby's health in various ways. In some cases, it can cause permanent medical conditions; in others, health-related problems may resolve as the child grows up. In children, preterm labor has been associated with cerebral palsy, breathing problems, learning disabilities, developmental delays and digestive issues. Preterm infants must often remain in the hospital in a neonatal intensive care unit for some time after birth to receive specialized care.