The following signs and symptoms confirms the occurrence of preterm labor:
The diagnosis of preterm labor precludes with the accurate determination of fetal gestational age that falls beyond 20 weeks and lower than 37 weeks, with concurrent regular contractions and vaginal spotting.
The following tests and procedures may be utilized to help in the diagnosis of preterm labor:
The following treatment modalities are done to prevent the progression of preterm labor to preterm delivery:
Patients with less frequent contraction without bleeding may still be able to tocolyze the preterm labor till term pregnancy. However, patients presenting with rapid contractions with eminent bleeding may have an increased chance to progress to preterm delivery.
The relative prognosis of neonates born through preterm labor varies directly with age of gestation, and varies inversely with the number of congenital defects seen. This prognostic relationship is also true with maternal and neonatal morbidity and mortality ratings respectively.
The following medical conditions are common complication of preterm labor:
The progression to preterm labor is influenced by the maternal health, lifestyle and inherent anatomical defects. The following etiologic factors may lead to preterm labor:
Preterm labor initiates more than half of preterm deliveries and is considered as the leading cause of neonatal mortality in the United States today . Preterm births accounts for the 70% of neonatal morbidity and mortality .
The relative risk of preterm births due to preterm labor may be averted by the prompt and early identification of risk factors among mothers with less than 37 weeks of gestation. The active reduction of extreme prematurity (less than 32 weeks) will significantly reduce the mortality, morbidity and the inherent expenses during the delivery .
The pathophysiology of preterm labor lies on the nature of the inciting factor that induces labor. Preterm infection like chorioamnionitis or maternal septicemia may trigger uterine labor prematurely. The relative mass of the conceptus pressing against the thinning cervix may be influenced by twining or multiple pregnancies. Consequently, the cervical competence and amniotic fluid volume is also an important contributory factor in the progression of the preterm labor.
Mothers who begin to feel uterine contractions should take a short walk, change position or rest for a few minutes to quell the preterm contractions at home. Frequent false contractions in the preterm period is a risk factor for preterm labor in the late preterm stages (34-36 weeks) .
Persistent contraction despite these remedies must be brought in to the nearest obstetric care facility for proper assessment and monitoring. Adequate rest and fluid intake during intermittent uterine contractions may prove to be beneficial in some cases of preterm labor.
Preterm labor is a clinical condition defined as the premature opening of the cervix due to frequent uterine contractions before 37 weeks of gestation. When such event is unabated, this may result to the delivery of a premature baby that may require special care upon birth and may be at risk to long term complications. Mothers who underwent preterm labor may be at risk to another preterm labor on her next pregnancy.
Preterm labor is defined as the frequent uterine contraction that lead to the opening of the cervix before term pregnancy.
Frequent uterine contractions with shorter intervals, bleeding per vagina, cervical effacement and early rupture of membranes are common symptoms.
Pelvic examination, ultrasound, fetal and uterine monitoring and amniocentesis are used to diagnose preterm labor.
Treatment and follow-up
Cervical cerclage, corticosteroids to enhance fetal lung maturity, and tocolytics to control preterm contractions are the treatment options.