Preterm Labor and Birth
Preterm Labor and Birth
Contractions and dilation (opening) of the cervix before 37 weeks of pregnancy are considered preterm, or premature, labor. A normal pregnancy lasts about 40 weeks after the first day of the last period (38 weeks after fertilization). The danger of preterm labor is that it will lead to the birth of a baby that has not fully developed, and therefore has a high risk of complications. About 10% of all pregnancies result in premature birth. About 60% of serious complications or infant deaths are due to consequences of premature birth.
Preterm labor can be extremely frightening, because mothers-to-be quite naturally fear that their baby will be born too early and suffer the problems of prematurity. If your baby is born too soon, there is a great chance that her lungs will be underdeveloped. If so, she'll need to be put onto a ventilator that can breathe for her. Receiving oxygen through a ventilator can lead to complications.
Your baby may also have trouble maintaining a normal body temperature, and may become hypothermic (too cold). She'll need to be kept warm. Your baby might be so early that she can't coordinate her muscles to suck and swallow. If this is the case, she'll have to be fed through a needle in the vein (intravenously), or through a tube passed into her nose, down her throat and into her stomach. A premature baby may also develop complications such as bleeding into the brain; an increased risk of infections, especially meningitis and sepsis; problems with kidney function; and jaundice. Premature babies are at higher risk for long-term complications, which may include vision impairment or blindness, hearing impairment, cerebral palsy and chronic lung problems. The earlier the baby is born, the more likely that she will have these complications.
You are more likely to experience preterm labor if:
Premature delivery may be preceded either by contractions or premature rupture of the fetal membranes (PROM), when the water breaks before labor begins. Although there have been many advances in caring for premature babies, there has been no improvement in solving the problem of preterm labor or PROM. We don't completely understand why some women go into labor or break their bag of water too early. We are often unable to accurately predict which women will do so, and we are limited in preventing these women from giving birth prematurely. In some cases, an infection may be involved; in others, it may be an abnormally short cervix or a combination of factors. In about half of all cases, no cause can be found. The number of babies born prematurely in the United States has actually risen in the last 10 years.
Diagnostic and Test Procedures
If you go to your health-care provider or a hospital because you think you may be in preterm labor, monitors will be placed on your abdomen to measure your baby's heart rate and record any uterine contractions that you have. The doctor will do a pelvic examination to check if your cervix is dilating. If you report that you think your water has broken or if the doctor sees any fluid coming from the cervix, he or she will take a small sample of fluid in order to determine whether it is truly amniotic fluid. If it is, a sample may be sent to a laboratory to determine how mature your baby's lungs are. Alternatively, your doctor may choose to perform an amniocentesis, which can provide information about your baby's lung development. Swabs of your cervix will be sent to a laboratory to test for infection, such as the presence of beta Strep. Your practitioner will want to test your urine for infection. You may be asked to provide a urine specimen, or your practitioner may put a tiny tube in your bladder (catheter) to remove a urine sample.
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