Pre-term Labor

Pre-term Labor

Pre-term labor is the onset of contractions occurring with enough strength and frequency to dilate or open the uterine cervix prior to 37 weeks of the pregnancy. While not all pre-term labor results in pre-term birth, over 70% of all pre-term births are due to pre-term labor. Since the emotional and economic impact of a premature baby is tremendous, one of the major goals of obstetrical care is preventing pre-term labor to decrease the chance of pre-term delivery.

Pre-term labor occurs in 12% of all pregnancies. While every case is different there are some general steps all pregnant women can take to reduce their risk. The chance of pre-term labor is greater in women who smoke cigarettes, consume alcoholic beverages during pregnancy, and are under or over weight. There is also a greater risk if the uterine cavity is abnormal due to fibroid tumors or a uterine malformation. Multiple fetuses raise the risk of pre-term labor, and that risk increases with the more fetuses a woman carries. Medical care prior to becoming pregnant can help a woman assess her risks and reduce them before pregnancy.

A frequent cause of pre-term labor is pre-term rupture the bag of waters before contractions begin. Labor will likely ensue within 24 hours. Scientists have determined infections frequently can cause pre-term labor and pre-term rupture of the membranes. Tests early in pregnancy are directed at diagnosing the presence of infection making early prenatal care important in preventing pre-term labor.

Signs and symptoms of pre-term labor include increase in the vaginal discharge, vaginal bleeding even when it is very light, regular contractions of the uterus with greater frequency than every 10 minutes, and an increase in pelvic pressure. A woman should contact her physician if any of these symptoms occur. The earlier pre-term labor is detected, the greater the chance of preventing pre-term birth.

In women who have had one pre-term birth, the risk of a second is 15%. With two preterm births the risk rises to 30%. To try and prevent pre-term labor these patients are seen more frequently during the pregnancy. They are monitored closely for cervical shortening (which occurs before dilatation), contractions that may not be felt, and infections. A test called fetal fibronectin can help with predicting the risk of preterm birth. The presence of fetal fibronectin (FFN) indicates a 60% chance of labor in the next two weeks.

Injections of progesterone have been used successfully to decrease the risk pre-term labor. Given weekly beginning between 16 and 20 weeks of the pregnancy until 36 weeks, these progesterone injections reduced the risk of pre-term delivery by more than 18%. Physicians and scientists are constantly studying such methods, again pointing to the importance of early care with a physician for all pregnant women.

Pre-term labor is a serious complication of pregnancy. Assessing the risk and decreasing any known risk factors can help prevent pre-term labor. Knowing the warning signs and contacting a physician if they appear can be important in preventing preterm delivery.

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