Preterm Labor, Premature Signs,Causes,Treatments
Preterm Labor: Is defined as rhythmic uterine contractions that produce cervical changes prior to completion of 37 weeks of gestation.
signs and symptoms of preterm labor:
– Vaginal discharge watery, mucus or bloody.
-A pressure in the pelvis or lower abdomen, because of the baby is pushing down.
-abdominal cramps without diarrhea
– Regular or frequent contractions may not be painful.
What Causes preterm labor?
- Upper and lower extremes of age.
- Lower socioeconomic status.
- Inadequate prenatal care.
- Race ( increase in blacks).
2- lifestyle and employment.
- Smoking and drug abuse.
- Prolonged periods of standing.
- Fatigue and long hours of work.
- Heavy work and lifting.
3- Reproductive history:
- Previous preterm delivery, getting pregnant less than six months after having your last child.
- Incompetent cervix.
- Spontaneous or induced abortion.
- Being over the age of 37.
4- Uterine anomalies e.g. leiomyomata.
5- Weight again: low weight or low weight gain may increase risk.
6- Anemia: probably due to other risk factors.
7- Uterine size and placental abnormalities:
- Multiple gestations.
- Placenta previa (an abnormal placentation near or covering the internal cervical os).
- Polyhydramnios (an excess of amniotic fluid in the amniotic sac).
- Abruptio placenta (premature separation of the placenta).
8- Premature rupture of membranes.
9- Vaginal bleeding.
10- Surgery: abdominal procedures.
11- Infection: an infection during pregnancy UTI, pneumonia, malaria, typhoid fever, syphilis, gonorrhea, amniotic fluid infection, vaginitis.
12- Other associations:
- Fetal gender ( male fetuses have a shorter gestation period).
- low magnesium level.
- Cervical dilation.
- Membranes: ruptured or not.
- Presences of severe preeclampsia and hemorrhage.
- Ultrasonography: to determine fetal gestational age, condition, and weight.
Management and intervention:
- Special prenatal care for high-risk women.
a- Frequent visits for weeks 22 to 32.
b- Urine culture at 24 weeks.
c- Vaginal examination for pH.
d- Education on nutrition and preterm labor.
Signs and symptoms reinforced :
- Increase or change in vaginal discharge.
- Uterine contraction.
- Vaginal bleeding or leaking fluid.
Bed rest and hydration: increase uterine blood flow.
Fetal maturation therapy: Glucocorticoids therapy.