Preterm Labor, Premature Signs,Causes,Treatments

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Preterm Labor
Preterm Labor

Preterm Labor

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?

1- Demographics:

  • 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.

Assessment:

  • 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.

Continuous monitoring

Fetal maturation therapy: Glucocorticoids therapy.

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