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What to do when threatened with preterm labor

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If the pregnancy for a woman ends before the deadline set by the doctor, and the child is born, premature labor takes place. The degree of threat to the health of a new person completely depends on the number of obstetric weeks, how much the mother carried the baby under her heart. It is important to recognize the potential causes of premature birth, in order to avoid such a sudden delivery and its dangerous consequences for children's health in the future.

What is preterm labor

Ancestral activity, completed by delivery earlier than 38 obstetric weeks, characterizes the pathological labor. For the health of the baby, it is a pathological process, however, thanks to modern technologies, doctors have learned how to nurse children born from 28 obstetric weeks and beyond. However, health problems still can not be avoided, because the fetus has not yet fully completed its intrauterine development. Therefore, if there is a threat of premature birth, a pregnant woman is urgently placed on conservation.

The longer a child stays in the womb, the greater the chances of his birth being strong and healthy. However, the situations are different, and it is not necessary to exclude the cases when a woman does not manage the term set by the gynecologist for pregnancy. The characteristic signs of preterm labor are not much different from the natural labor, and the first harbinger is the leakage of amniotic fluid.

Since the baby in the second half of pregnancy is characterized by increased physical activity, diagnosis can be difficult. However, a vigilant future mom should pay attention to the following alarming symptoms:

  • increasing the tone of the uterus during palpation,
  • pulling or cramping lower abdomen,
  • constant fetus activity,
  • frequent urging to the toilet,
  • pulling feeling in lumbar region,
  • bursting feeling in the vaginal area.

How to start

If there is a pulling pain in the lower abdomen, while the woman discovers the leakage of amniotic fluid, you should immediately call an ambulance or immediately contact the local gynecologist with a complaint. Early labor can cause a miscarriage, which should not be allowed under any circumstances. Early labor begins with a sharp abdominal pain, which only increases in different positions of the body. Pregnancy is at risk, and it is better for a woman to agree to hospitalization.

Most future moms ask the main question, how to avoid preterm birth. In fact, the first step is to find out in detail why this pathological process is progressing, and how to reduce the risk of the late appearance of the crumbs into the light. This is reported by the specialist when planning a pregnancy in order to save a woman from subsequent problems during 40 obstetric weeks. In modern obstetric practice, the following causes of preterm labor are distinguished:

  • previous abortions, instrumental cleaning of the uterus,
  • abuse of bad habits
  • infection of the cervix and vagina,
  • rhesus conflict
  • polyhydramnios and mnogoplodie
  • premature aging or placental abruption,
  • pelvic presentation of the fetus,
  • intrauterine infections
  • fetal gene mutations,
  • antiphospholipid syndrome,
  • severe forms of preeclampsia,
  • rupture of membranes,
  • cervical insufficiency,
  • excessive sexual activity
  • the presence of hidden urinary tract infections,
  • diabetes during pregnancy
  • pathology of the thyroid gland in the future mom,
  • preeclampsia
  • multiple pregnancy (twins),
  • female inflammation during pregnancy
  • uterine bleeding.

Classification

Early births are not considered a disease, but the general condition of the newborn is completely dependent on the time of early delivery. If it was not possible to bring the child up to the 40th obstetric week, the conditional classification is presented below, which gives at least a distant idea of ​​the extent of the pathological process and the potential diseases of a person born:

  1. Very early childbirth. Premature appearance of the crumbs falls on a period of 22-27 weeks. The weight of the fetus varies in the range of 500-1000 g, the doctor diagnoses the underdevelopment of the internal organs and systems, problems with disclosure of the lungs.
  2. Early childbirth. Premature birth of a child falls on a period of 28-33 weeks. A child weighs up to 2 kg, while the natural ventilation of the lungs is impaired, the circulatory system is imperfect.
  3. Preterm birth at 34-37 obstetric week, although considered pathological, but encouraging parents, since all the internal organs and systems have already been formed. The newborn weighs about 2 500 g.

Indications for artificial preterm labor

In practice, there are cases when doctors deliberately insist on premature, rapid stimulation of labor. The need for this arises in the diagnosis of extensive pathologies in the body of the mother or child. In addition, the life of both could be threatened. Such critical moments is the detection of the following pathologies:

  • decompensated endogenous diseases of a complicated form that are fatal for the patient,
  • preeclampsia and eclampsia, as a manifestation of severe preeclampsia, fraught with inevitable death of the infant,
  • extensive liver pathologies in pregnant women, when the natural flow of bile is pathologically disturbed,
  • Diagnosis in the body of a pregnant woman HELLP syndrome with increased activity of liver enzymes,
  • intrauterine malformations, incompatible with the continued viability of the fetus,
  • fetal death of the fetus, fraught with infection and blood infection of a pregnant woman.

How to call

If you suspect a pathology or the presence of one of these pathological factors, a pregnant woman is taken to the hospital. In determining the diagnosis and the need to stimulate childbirth, doctors prematurely use individual medications that are commonly introduced into the vagina intraamniotically. In this case, we are talking about the following medicines: the synthetic hormone Mifepristone is complex with Misoprostol, Oxytocin, Dinoprostone and Dinoprost. Superficial self-treatment is contraindicated, since there is a high probability of death of the mother and child.

Diagnostics

In case of internal deviation of the intrauterine development of the fetus, labor can begin before the prescribed period. The hypertonus of the uterus, the discharge of amniotic fluid, dilatation of the cervix of the genital organ, and acute pain syndrome that attacks the mother's mind with cyclical attacks suggest such thoughts. An additional method of examination is ultrasound, which determines the state and position of the fetus in the womb. Before stopping acute pain, the doctor may prescribe a special test to confirm the onset of labor.

A special test system called Actim Partus reliably determines the binding insulin-like growth factor - 1 (SIPFR) in the mucus of the cervical canal. The enzyme in capacious concentration is produced by the fetal membranes of the embryo several days before the onset of labor. It is possible to conduct such a laboratory study only in the hospital, since it is not possible to organize the collection of material at home without special equipment and tools.

How to prevent

Since the baby is born prematurely at an early stage, with low body weight and extensive lesions of the internal organs, the doctor’s task is to stop preterm birth with medical preparations, alternative methods can be used. Since labor can start at any time, a woman should be hospitalized first, examined, and then prescribed effective treatment, left under strict medical supervision. If you act correctly, the baby can be born on time, without pathologies.

Dexamethasone with the threat of preterm birth

Doctors use synthetic glucocorticosteroids to prevent the development of respiratory distress syndrome. With the threat of early labor, the drug Dexamethasone for intramuscular administration has proven itself well. It is allowed to use it strictly for medical reasons at an obstetric period of 24 - 34 weeks. There are two schemes for the use of this drug:

  • 12 mg twice in 24 hours,
  • 6 mg for 4 visits during the day.

Conservative inpatient treatment

The definition of a complex treatment regimen is carried out individually - according to medical indications after identifying the main cause (pathogenic factor) of progressive pathology. Doctors in the conditions of compulsory hospitalization to ensure positive dynamics and prolong the gestation period unite representatives of different pharmacological groups:

  • antispasmodic drugs intramuscularly or rectally: No-shpa, Drotaverinum, Papaverin,
  • intravenous adrenomimetics: ritodrin, terbutaline, ginipral,
  • NPVS rectally: Indomethacin from 32 weeks of pregnancy
  • glucocorticosteroids, gestagens orally or intramuscularly: Progesterone, Utrogestan, Dexamethasone.

Management of preterm labor

To avoid potential complications with children's health, intensive care should be carried out in the hospital. A positive result will definitely be, if you strictly follow all medical prescriptions. There are several methods of dealing with such a global violation, it all depends on the general condition of the patient, the fetus. Below are a few effective tactics that are chosen by the doctor, based on the complexity of the specific clinical picture:

  1. Expectant tactic. Women are provided with peace - physical and emotional, give soothing teas, use mild sedatives and antispasmodics.
  2. Active tactics. If the cervix is ​​extended to 3 cm or more, doctors use epidural analgesia or drip intravenous Partusisten.

Implications for mother and child

For a woman, the effects of preterm labor are not so significant, they are more associated with the physiological characteristics of the female body. For example, the perineum can be torn, or the doctor performs a caesarean section with further suturing. But for a baby, the consequences of a premature birth can seem fatal. It all depends on the time of birth. As an option:

  • severe birth injuries
  • congenital diseases
  • early mortality.

Pregnancy after childbirth premature

After a pathological childbirth, a woman’s body should be restored properly, so it’s definitely not recommended to hurry with a second conception. Doctors advise to see a gynecologist for a year, undergo a complete medical examination, promptly treat hidden diseases (if any), and then think about the next replenishment of the family.

Prevention

To avoid complex decisions and dangerous consequences for the health of the infant, it is required to take a responsible approach to the period of pregnancy planning, to undergo a complete medical examination in a timely manner. If the successful conception has already happened, it is important:

  • time to register for pregnancy
  • eliminate bad habits
  • take vitamins
  • beware of taking certain medications,
  • eat correctly and fully
  • regularly go to the ultrasound,
  • Avoid infectious and viral diseases.

What are dangerous preterm birth?

This condition usually indicates the presence of any pathology or problem and requires urgent assistance from doctors. Premature birth is called if the process began in the period from the 22nd to the 37th week and ended successfully.

The most dangerous is the occurrence of a threat in the period up to the 28th week, when the weight of the infant only rarely exceeds 1 kg. The viability of the baby is minimal, since the newborn is not fully mature. After the 29th week, when the weight of the infant is usually already more than 1 kg, he has more chances to live.

But even if the threat of premature birth occurs at week 33, doctors do everything to give the baby as much time as possible to fully develop inside the womb, stopping incipient contractions and eliminating other symptoms.

Children born prematurely often do not have the necessary reflexes, since their nervous system did not have time to ripen. Their protective functions are greatly impaired due to the underdevelopment of the endocrine organs. Such babies are very vulnerable and need very special, very thorough and long enough care.

Why is this happening?

As a rule, premature birth of a baby is possible if there is a rupture of the membranes of the fetus, the appearance of real contractions or other complications. The causes of the threat of preterm labor are different, for example:

  • Excessive use of a variety of drugs, especially those prohibited during the gestation period. For example, antibiotics taken with the threat of premature birth can significantly complicate the situation and create many additional problems. It is important to remember that in this period you can take only those funds that (if necessary) appointed by the doctor, while strictly observing the dosage.
  • Use in the period of carrying any alcoholic beverages, as well as narcotic drugs.
  • Inadequacy of nutrition or its improper organization. For example, it should be noted that the use of products containing zinc, can prevent possible premature birth.
  • Excessive weight gain. It is important to remember that the normal increase for the whole period is from 8 to 12 kg.
  • Heavy physical activity associated with working or lifting weights.
  • Spending most of the day in a standing position, especially in the second half of the gestation period.
  • The presence of an imbalance of hormones.
  • Leading a fairly active sex life (orgasm causes uterine contractions).
  • A variety of diseases of infectious etiology.
  • Insufficiency of uterine cervix size.
  • Increased sensitivity of the uterine walls. In this case, the time of hospitalization with the threat of preterm birth begins with the transition to the last third of the period.
  • The wrong location of the baby.
  • The presence of any degree of placenta previa.
  • Complications of pregnancy.
  • The presence of chronic diseases.
  • Constant stressful situations.
  • Low social level and poor living conditions.
  • The early (up to 18 years old) or late (after 35 years old) age of the future mom.

Signs of a dangerous condition

Symptoms of the threat of preterm birth include:

  • Pain pressing or pulling nature of varying intensity in the lower lumbar segment.
  • Cramps, very similar in feeling to menstrual. The condition may be accompanied by diarrhea or nausea.
  • The appearance of abnormal (bloody or dark) vaginal discharge.
  • Squeezing the crotch area.

What to do when a threat occurs?

Of course, if any signs appear, you should immediately call a doctor and, if he insists on hospitalization, do not refuse. It is important to preserve the pregnancy in any way to give the baby a full development.

Today, doctors use a lot of tools to help women in the event of conditions that threaten the premature onset of labor. Most often for this purpose can be used a variety of drugs, in particular:

Dexamethasone when threatened with preterm labor is assigned to a woman as a safety net, if the process that has begun cannot be slowed down and the baby will appear prematurely. The purpose of the drug in this case is to accelerate the development and maturation of the lungs and the general respiratory system of the infant. The means for hospitalization is usually injected by injection into the muscle of the buttock, but may also be prescribed in tablet form.

The drug in the period of carrying a baby according to the instructions is contraindicated, but, nevertheless, it is very often used to save pregnancy and suppress androgen synthesis. Often it is the excess of this hormone that causes premature birth, especially when carrying a boy, because the organism gradually begins to produce its own natural androgens, which are added to the parent and cause failure.

The purpose of the remedy is always individual and depends on the evidence and the condition of the woman. On average, it can be prescribed to take from 1 to 3 tablets during the day, as well as from 2 to 4 shots with an equal time interval per day.

The drug is available in the form of special capsules, and its safety for women in the position makes the tool indispensable in many situations. The use of substances is possible both by oral route and by inserting into the vagina in the required dosage (100 or 200 mg each). Эффективность средства значительно выше именно при вагинальном введении, но, кроме этого, при таком применении у женщины наблюдается гораздо меньше негативных реакций, в частности, отсутствует состояние сонливости, не возникает головокружений.

Urozhestan with the threat of premature birth is used as a sedative and relaxing means, especially during the first and second third of the period, while the capsules are inserted into the vagina twice a day. In the last third of the use of the substance is possible only with caution, because in this period the drug creates a significant burden on the liver and can cause disruption to the body.

The important point is the gradual elimination of the substance, by regularly reducing its dose. If you abruptly discontinue the use of Utrozhestan, the condition for which he was designated to eliminate, will quickly return, but in a more serious form.

The drug has a fairly pronounced vasodilating effect, so that the main area of ​​its use is cardiology. In the period of carrying a baby, it is contraindicated, but, nevertheless, it is used quite often.

With the threat of preterm labor, nifedipine is most often prescribed to eliminate uterine hypertonus, but only after 16 weeks. In the first third of the period of the funds are not used, because the doctors do not have complete confidence that its introduction will not affect the formation of the future baby.

A remedy can also be prescribed in the presence of pressure drops in the future mommy, especially in cases where there are irregularities in the work of the heart system and blood vessels, as well as diseases in this area. The application scheme is always assigned strictly individually. The correct dosage will reduce the risk of adverse reactions in the form of headaches, swelling, drowsiness, and hyperemia of the face.

Most often during hospitalization, doctors use Magnesia droppers with the threat of premature labor, which allows you to quickly relax the uterine walls and reduce the level of tone. But among the testimony in the period of gestation, and the presence can be noted:

  • susceptibility to the formation of blood clots,
  • arterial hypertension,
  • severe puffiness
  • preeclampsia,
  • convulsions
  • magnesium deficiency.

The tool is highly effective, but not every pregnant woman carries such droppers easily. In most cases, the introduction of a substance can cause headaches, hot flashes or chills, nausea and vomiting, heart rhythm disturbances, thirst, anxiety, shortness of breath, and even speech confusion. In the presence of hypotension, slow heart rhythm (bradycardia), disorders of the kidneys, individual sensitivity to the substance and exacerbated ailments of the gastrointestinal tract, the drug is not prescribed. Do not use it in the last weeks of gestation, so as not to slow down the timely natural childbirth and not to reduce their activity.

Obstetric pessary - this is the name of a special ring used in case of a threat of premature birth. The device is a special gynecological device, which aims to maintain the growing uterus, as well as the intestine, bladder and the redistribution of the total load. The ring has smooth edges and is made of a biologically pure plastic material, therefore it cannot cause any harm.

Installing funds on the uterine cervix is ​​unpleasant enough, although it does not cause pain. The procedure does not last long, so discomfort can be tolerated, because this measure allows you to save the pregnancy even with the failure of the uterine cervix, as well as significantly prolong the gestation period when several fruits develop inside.

There are no contraindications to the installation of such a ring, but it is important to choose the right size, and only an experienced doctor can do it. An important point for successful and correct installation of the device is the preliminary elimination of infections, if they are present, for example, candidiasis, which is so often exacerbated during this period. The item is removed 1–2 weeks before the expected day of birth.

Thanks to the methods of modern medicine, the chance to have a child without any pathologies has significantly increased in time. Qualified doctors and timely measures to preserve pregnancy and prevent preterm birth regularly help to give birth to healthy babies.

Preterm birth and gestational age.

Premature delivery at 22-27 weeks.
Appeared at this stage of pregnancy, children have the lowest percentage of survival, because their lungs are not yet mature, and their weight is within 500-1000 g. The main factors that provoked premature birth at this stage of pregnancy are cervical insufficiency, infection of the bladder and its gap. A child born at 22-23 weeks has almost no chance of survival, and not many who survive (and there have been such cases in obstetric practice) continue to become disabled. Those who were born from 24 to 26 weeks are more likely to survive, and the prognosis for their health is much better. Preterm delivery from 22 to 27 weeks of gestation occurs in only five percent of cases.

Premature birth at 28-33 weeks.
Most of the children born at this time survive safely, which is largely due to the high level of development of neonatological care, but it is worth noting that the fact of prematurity is not without consequences for all children. Usually, children of this group have a weight of from 1000 to 1800 grams, their lungs are practically prepared for breathing. At this time, preterm birth can occur for a variety of reasons, ranging from pregnancy complications to rhesus conflict.

Premature delivery at 34-36 weeks.
To be born on this period of pregnancy for the child is not dangerous. Born in a maternity hospital, a healthy, but premature baby has all the chances for quick adaptation and good health in the future. The weight of babies born on this period is usually more than two kilograms, the lungs are ready for independent work, and little support is needed with medicines to speed up their maturation. The main culprits of preterm labor at this time are considered to be the somatic diseases of the future mom, various complications of the course of pregnancy and intrauterine hypoxia against the background of feto-placental insufficiency.

Symptoms and signs of preterm labor.
Signs of preterm birth can be compared with the threat of abortion in the early stages. Most often, the outbreak of amniotic fluid speaks about their beginning, but a few days before this, a woman usually has symptoms-precursors, to which she does not pay, as a rule, attention.

In obstetric practice, there are several stages of preterm labor:

  • Threatening preterm labor. During this period, the symptoms of preterm labor can not even be noticed. These include pulling pain in the lower back and lower abdomen of a weak nature, tension or contraction of the uterus, which can be seen by placing a hand on the stomach (usually it stiffens), restless behavior of the baby (often kicks), the appearance of mucus from the genital tract (when viewed from the uterus tight and closed). Going to a doctor at this stage will help avoid premature birth, usually prescribed minimal medication and absolute rest is recommended.
  • Beginning preterm labor. Symptoms are more pronounced, in particular, pain in the lower back and lower abdomen become more intense, tight. At this time, the mucus plug often departs, discharge from the genital tract of bloody nature is observed, and water often pours out. During the examination, the specialist reveals a shortening and softening of the cervix, its opening by 1-2 fingers.
  • Started preterm labor. Usually, if the birth process has begun, it will not slow down. Often, preterm labor has a rapid flow, for example, in nulliparians, they disappear within 6 hours, with repeated births this time can be reduced by half. The pains become very intense, acquiring a cramping character, and the contractions become regular (every ten minutes or less), the cervix rapidly opens, water flows away, the fetus is pushed to the entrance to the small pelvis.

So, if there were pains that resemble pain during menstruation, a feeling of heaviness in the lower abdomen and pressure on the bottom, fetal activity increased significantly or, on the contrary, weakened, unusual discharge from the genital tract appeared, you should know that these are the first signs of premature birth. In this situation, in order to “calm down” your “hurry”, you should seek medical help immediately. Any delay can cost you dearly. In any case, it is better to be safe in advance than to regret your short-sightedness and carelessness.

Treatment of the threat of preterm labor.
Usually, if a pregnant woman turns to a doctor at the stage of threatening preterm labor, she is recommended hospitalization at the maternity hospital, but not in all cases it is so necessary. Of course, first a gynecological examination is performed, tests are taken, the condition of the cervix and the child is evaluated, and the presence or absence of infection in a woman is detected.

More worth staying on the leakage of amniotic fluid. Very often, because of fear, women do not go to the doctor if the waters have withdrawn, and the contractions have not yet begun, but in vain. In this case, no one will immediately terminate the pregnancy (there is nothing to be afraid of), especially if its terms have not reached 34 weeks. In the absence of signs of infection, the pregnant woman is simply placed in the maternity hospital, where for several days (five to seven or more) specialists will prepare the fetal lungs for independent work (usually prescribed glucocorticoids), the pregnant woman herself will be protected from infection by antibiotic therapy and creating sterile conditions . Delivery will occur only after the fetal lungs are ready so that the child can breathe on his own. Prolongation of pregnancy in case of premature rupture of the membranes of peritoneum is carried out on the basis of the timeliness of treatment and the state of the pregnant at the time of treatment.

With the threat of premature birth for a period of 35 weeks or more with the outpouring of the amniotic fluid, the pregnant woman gives birth, because the adaptation of such children to extrauterine life passes, as a rule, successfully. If the amniotic bubble is preserved, the treatment is aimed at stopping the commenced labor and eliminating the cause of it. If there is only the threat of premature birth, outpatient treatment is sometimes possible, but in most cases hospitalization is recommended. Often, creating a calm environment for a pregnant woman is enough to stop the birth activity and continue the pregnancy.

If the birth process has begun, it will not stop. If the fetal bladder is intact, then drugs are used as a therapy, the action of which is aimed at relaxing the uterus, and also introduces sedative therapy, physiotherapy and bed rest.

If the treatment was unsuccessful, the contractions did not stop, and grow with each time, the question of delivery arises.

The danger of rapid preterm birth.
As a rule, premature labor with rapid nature is always associated with hypoxia, which is due to frequent uterine contractions and too rapid movement of the fetus through the birth canal. Soft bones and small sizes of the fetal head, as well as weak blood vessels in combination with the above, can provoke severe birth injuries of the fetus, intracranial hemorrhages and injury to the cervical spine. By the way, precisely because of how the birth process proceeded, in the case of premature birth, a premature baby may suffer, and not because of the fact of prematurity.

If the experts failed to stop the preterm birth, they are doing everything to ensure that the birth goes as carefully as possible. No methods of protecting the perineum from tearing are used, as this can cause fetal injury. Even in the case of gluteal presentation of the fetus, childbirth is carried out in a natural way (in the absence of contraindications), and in the hospitals all the conditions for nursing newborns are created. In the case of deep prematurity, a cesarean section is performed.

In the case of discoordinated labor or its weakness, careful labor is carried out with thorough anesthesia, careful stimulation with simultaneous monitoring of the fetus.

If the pregnancy is extended after the use of amniotic fluid, the likelihood of endometritis and postpartum hemorrhage is high. Preterm delivery at 35 weeks has virtually no complications.

Caesarean section for preterm labor is not used if the fetus is not deeply full, but there are clear signs of chorioamnionitis and intrauterine infection, as well as in the case of intrauterine death of the fetus.

In these situations, natural childbirth is necessary, cesarean section is a threat to the life and health of the woman.

Prevention of preterm birth is to eliminate the factors that cause them at the planning stage of pregnancy. Therefore, it is very important to be healthy at the time of pregnancy, or if it happened by chance, it is necessary to register and be examined as soon as possible.

Types of preterm birth

By the term of pregnancy, preterm labor is divided into 3 types:

  1. Very early - preterm labor at week 22-27 - the weight of the fetus during this period is usually from 500 to 1000,
  2. Early preterm birth at 28-33 weeks - the weight of a newborn from 1000 to 2000,
  3. Premature birth at 34-37 week - child's weight about 2500 g.

Share also the threat preterm labor beginning and started preterm labor. The type of treatment will depend on the type of preterm birth, the timing, and the general condition of the mother and child.

In addition, the chance of a child’s survival also depends largely on the period at which premature labor takes place. However, in any case, the longer the baby is in the womb, the better for him. And every day, which will be able to postpone childbirth, will make it healthier and stronger.

Preterm labor statistics

As an encouraging moment for women who are overwhelmed by the fear of preterm labor, one can cite general statistics on preterm labor. Note that only 6-8% of all deliveries are premature. Just think, only 8 out of 100 women give birth prematurely, the rest wear their children safely.

And from this number only 5-7% falls on periods from 22 to 27 weeks. Of course, it’s harder to get such children, but quite a few manage to save lives. In the period from 27 to 33 weeks, a little more than 30% of premature babies are born. It is much easier to go out with such babies, of which more than half survive.

More than 50% of all preterm births fall on 34-37 weeks. Kids that appeared during this period differ from full-term only in size. All systems in their bodies are already sufficiently developed to exist independently in the outside world.

As you can see, the absolute majority of women have absolutely nothing to worry about. The rest is important to consult a doctor in time. The sooner treatment is started, the greater the chance of a happy outcome.

Causes of Preterm Birth

What are the causes of preterm labor? They exist just a huge amount. In the early stages it is usually different inflammation and infectious diseases. Any inflammation in the uterus affects the muscle tissue and prevents them from stretching. But with the growth and development of the baby, the uterus must constantly stretch. If there are any obstacles to this, the uterus tries to throw off the fetus, and preterm labor begins.

This is one of the reasons why doctors so strongly recommend taking tests for infectious diseases before conception. Ideally, infections should be treated before pregnancy. However, if you have not done this in advance, then it's time to do it at the beginning of pregnancy.

In any case, throughout the pregnancy, you need to be checked for infectious diseases. The sooner the disease is detected and treatment is initiated, the greater the chances of maintaining the pregnancy.

Premature birth at 27-29 weeks and later most often begin because pathology of the cervix uterus, which is called history of church failure. With this pathology, the cervix is ​​too weak to hold a gradually increasing fetus. As a result, under its pressure, it begins to unfold, which provokes the onset of preterm labor.

It is extremely rare for ICN to be congenital. Most often, this pathology becomes a direct consequence of abortions and miscarriages, after which you have to scrape the uterus, or other artificial interventions in this area, when you have to use the special tools to expand the cervix.

It follows that women after abortion, especially if it was made in the first pregnancy, after miscarriages and complex gynecological diseases, the risk of preterm birth increases.

Впрочем, иногда причина ИЦН кроется в избыточном количестве мужских половых гормонов в организме женщины, которые вырабатываются в надпочечниках матери, а начиная с определенного срока и в организме ребенка.

Инфекционные заболевания и патологии матки – это лишь самые распространение причины преждевременных родов. Есть и другие. So, многоплодная или многоводная беременность, в ходе которой происходит чрезмерное растяжение матки, также может закончиться родами раньше срока.

We must not forget about the pathologies of the uterus. Infantilism, saddle or two-horned uterus can also cause preterm labor. Various endocrine diseases also rarely lead to preterm labor, including diabetes or thyroid abnormalities.

In addition, it is noted that the risk of premature birth is higher for women from disadvantaged families, has an impact and hard workpermanent stresses, smoking, alcohol, drugs.

If a woman has already had a premature birth in the past, in subsequent pregnancies the likelihood of a recurrence increases.

As you can see, there are a lot of reasons. However, even if you have one or several signs, it does not mean that it is you who will certainly give birth ahead of time. In most cases, as you remember, women manage to carry the child through to the end of the pregnancy.

Moreover, if you know about all your problems, it means that doctors will monitor your condition and will certainly be able to prevent an undesirable situation.

Symptoms of preterm labor

As mentioned above, the longer the child is in the womb, the more viable and healthy he will be born. From this it follows that it is very important in time to assist the woman who has given birth, and, if possible, stop them. So, it is very important to consult a doctor in time. And for this you need to know the symptoms of preterm labor.

Stop the process is really possible, but only if it comes to threatening and beginning childbirth. In the event that labor activity has already begun, and the cervix has begun to open, it is impossible to stop childbirth. It remains only to carefully hold them and try to save the baby.

Signs of preterm labor is very important to know. Threatening preterm labor make themselves felt pain in the lower abdomen and lower back. The uterus is in good shape, making the stomach becomes hard. However, the cervix is ​​not disclosed.

Incipient preterm labor accompanied by colicy contractions of the uterus, rhythmic increase in the tone of the uterus. In fact - this is a full fights. In this case, the cervix begins to shorten and open. Quite often in this case there is an outpouring of the amniotic fluid.

How do preterm labor begin? In terms of symptoms, they are practically indistinguishable from ordinary ones, although they are not rarely accompanied by various complications: weak or, on the contrary, excessive labor activity, placental abruption, and bleeding. Often preterm labor takes much less time than normal.

Treatment with the threat of preterm birth

Having discovered the symptoms of premature labor, the first thing to do is to call an ambulance. Many women have a desire to get to the hospital on their own, but it is better to refrain from this. Unnecessary movements and loads can speed up the process of childbirth, and in a car or taxi there simply will not be the necessary preparations and equipment.

In addition, if preterm labor begins in the early stages, then it is very important to get to the maternity hospital, which specializes in such complications. In this case, in the hospital there will be not only the equipment and drugs that help to maintain the pregnancy, but also all that is necessary for nursing premature babies.

After a call to the ambulance, it is best to take a sedative, for example, valerian or motherwort. The antispasmodic also does not interfere, as a rule, in any house there is a burden. You need to take 2 tablets at once. After that, you need to lie down and wait for the doctor to arrive. Talk to your baby, promise that everything will be fine. Such communication usually calms a woman.

After arriving at the hospital, the pregnant woman will be first examined, including on the gynecological chair, in order to clarify the situation. Are we talking about preterm labor? What is the condition of the cervix and so on.

The treatment of the threat of preterm labor and beginning preterm labor, or rather their stopping, begins with the appointment drugs that reduce the tone of the uterus, for example, patrusiten or genipral. While the situation remains unstable, the drugs are injected intravenously. After stabilization of the condition of the pregnant woman, the injections are replaced with pills, and they are kept for up to 37 weeks, that is, until the term allows to consider the birth as full-term.

Do not do without sedatives. It is very important to normalize the psychological state of a woman. Stressful situation contributes to the development of preterm birth, and fear for the health of the baby is a very strong stress. A sedative will help break this vicious circle.

The next stage of treatment depends on what caused the situation. That is, in the event that a woman is infected, she will be prescribed a course of antibiotics. By the way, they will be prescribed, if the amniotic fluid departs for a period of up to 33 weeks or their leakage begins, and the child remains defenseless against all infections with which the mother contacts - a course of antibiotics is simply necessary. If the amniotic fluid leaves at week 34, preterm labor will not be stopped.

If we are talking about ICN, the treatment will also depend on the period. Until 28 week impose suture on the cervixto prevent its disclosure and to keep the pregnancy. The operation is performed under local, very short anesthesia.

In later periods, the cervix is ​​put on golgi ringwhich tightens the neck, and performs the same function as the seams.

Another drug that will be prescribed for pregnant women during preterm labor is dexamethasone. This drug does not contribute to the preservation of pregnancy, its task is to make the child more viable. The fact is that the biggest problem, due to which it is difficult to save the lives of premature babies, is that their lungs are underdeveloped.

In the lungs of children up to 37 weeks too little special substance - surfactant. It should cover the entire inner surface of the alveoli and prevent them from collapsing when breathing. The hormone contained in dexamethasone promotes the accumulation of a surfactant. If necessary, the same drug is administered to newly born children.

However, not in all cases, doctors will by all means try to keep the pregnancy. In some cases, when the situation threatens the life of the mother or child, obstetricians will not only stop the flow of labor, but, on the contrary, will stimulate them.

This is what happens with severe forms of preeclampsia, exacerbation of chronic diseases of the internal organs of a woman. With the outpouring of amniotic fluid after 34 weeks in the preservation of pregnancy is also not necessary.

Consequences of preterm birth for mother and child

What will be the consequences of preterm labor? For mother the consequences will be minimal. By and large, there are not many differences from ordinary births. Moreover, because of the small size of the child, crotch breaks are less common. In some cases, the woman is still detained in the hospital, but, as a rule, this is due to the condition of the baby.

However, it will still be necessary for her to undergo an examination in order to establish more precisely the causes of the incident, as well as the appointment of a treatment to prevent a recurrence of the situation.

Following pregnancy after a premature birth, the woman will be under constant medical supervision. Especially in critical periods. Naturally, the critical period at which premature labor began last time will be equal to the critical one.

Besides, deadlines are considered critical:

  • 2-3 weeks, when the attachment of the ovum occurs,
  • 4-12 weeks, at this time the placenta forms,
  • 18-22 weeks, at this time the most intensive growth of the uterus occurs.

Also, you need to be careful in the days when the calendar should have menstruation.

For a child the consequences of preterm birth will be more difficult, although much depends on how long the baby was born.

If a child is born for a period of up to 28 weeks, he is likely to be immediately transferred to a specialized hospital, where there will be all the necessary means that will allow for proper care of him.

This does not mean that the mother will not be able to see her child. Most likely, they will let her go to him, and if the condition of the baby allows, they will be allowed to feed and change diapers. In any case, the child really needs motherly love and care.

Babies born between 28 and 34 weeks are more viable, and the case may be dispensed by the intensive care unit in a regular maternity hospital.

After 34 weeks, the child’s organs are already sufficiently developed to exist in the outside world. He can already breathe, eat, digest food and remove waste. The only problem of premature babies at this time is underweight. In this case, the child may be with the mother in a regular ward.

In all three cases, the mother and relatives will have to spend a lot of time and effort in caring for a premature baby. However, the body of young children is very flexible, and most importantly, it is still developing, which means that the child will fully recover with time, and will not be anything different from other children.

How to recognize preterm labor?

Premature birth is divided into threatening and started.

When threatening preterm labor, there is a slight pulling pain in the lower abdomen and in the lower back, it is possible that the fetus in the uterus will move particularly actively, serous discharge from the genital tract may appear. If you experience these symptoms, a woman should immediately seek medical attention. With a vaginal examination, there are no changes in the cervix. Threatening preterm labor is a treatable condition, and with properly chosen therapy it can disappear altogether, and the expectant mother can safely reach the full-term gestational age.

Started preterm labor is characterized by regular labor and labor, the contractions are repeated first every 10 minutes, and then more often. The cervical dilatation is 4 cm or more, and the fetal presentation of the fetus is advanced through the birth canal. This indicates the irreversibility of the process of abortion. The task of the doctor at the same time is to carry out these deliveries as carefully as possible with the minimum risk of injury to the baby and the development of complications in childbirth.

What will doctors do?

The tactics of management of preterm labor depends on a number of factors: the stage of the course (threatening or beginning), the duration of pregnancy, the state of mother and fetus, the fetal bladder and the degree of cervical dilatation, the presence and intensity of bleeding, the presence of infection. All these indicators are evaluated when the expectant mother arrives at the maternity hospital.

Depending on the situation, doctors decide: whether it is possible to try to prolong the pregnancy or to take delivery.

Threatening preterm labor

With threatening or beginning preterm labor, gestational age up to 36 weeks, the whole bladder, good condition of the mother and baby, preference is given to waiting tactics. After all, during preterm labor, the prolongation of pregnancy for each week significantly reduces the risk of complications for the child. First of all, all pregnant women with threatening or beginning preterm labor are given bed rest, sexual and physical rest. Of great importance is the use of sedatives (sedatives) drugs that reduce anxiety, anxiety. If necessary, a perinatal psychologist is advised, psychotherapy is prescribed.

Treatment consists of reducing the excitability and suppressing uterine contractions (prescribed antispasmodics and other drugs), eliminating the cause of premature birth, accelerating the maturation of the baby’s lungs, improving microcirculation and preventing intrauterine hypoxia.

In order to enhance the effect of drugs, physiotherapy is also applied in parallel (electrosleep, electrophoresis of magnesium, acupuncture, electroplasty of the uterus). If necessary, to cure infectious diseases prescribe antibiotics.

With threatened preterm labor, prophylaxis of respiratory distress syndrome in the fetus is required (extremely severe manifestation of respiratory failure).

For this purpose, hormone preparations are prescribed, which contribute to the development of surfactant and the maturation of the fetal lungs. Surfactant is a substance that contributes to the smoothing of the alveoli of the lungs during inhalation and prevents them from falling out as you exhale. With a normal pregnancy, surfactant maturation ends by the 35–36th week of pregnancy.

If the cause of miscarriage is cervical insufficiency, then it must be corrected. There are two ways to deal with ICN: surgical and non-surgical. In the first case, a special supporting suture is imposed on the cervix (the cervix is ​​“sheathed” in a circle and tightened according to the “pouch” principle), which prevents its untimely opening. In the second, an unloading obstetric pessary is used (a special device in the form of a plastic ring that is installed in the vagina, fixes the cervix and takes on part of the load exerted by the pregnant uterus). In cases of pronounced manifestations of ICN, the non-surgical method is ineffective.

Women with threatening or beginning preterm labor against the background of amniotic fluid deserve special attention. With a gestational age of 28–34 weeks, no signs of infection, good condition of the mother and fetus, pregnancy can be prolonged. Of course, the premature rupture of amniotic fluid sooner or later leads to the development of labor. However, the shorter the period, the longer the time left between the outpouring of water and the onset of labor. This period can reach several weeks. The obstetricians use this precious time to give the baby some more time for maturation, and most importantly, to prepare his lungs as much as possible for independent breathing in extrauterine life. At the same time, pregnant women with premature rupture of water are prescribed antibiotics for the prevention of intrauterine infection (the fetal membranes no longer protect the baby, as before) and drugs that prevent the development of uterine contractions, i.e. restraining the onset of labor.

Doctors necessarily monitor the appearance of the first signs of infection of the birth canal: body temperature is measured 2 times a day, general blood and urine tests are performed, vaginal smear for flora is analyzed, bacteriological examination of vaginal sowing and careful monitoring of the condition of the baby. With the appearance of signs of infection, initiation of labor is initiated.

Early preterm labor

Started preterm labor is carefully and constantly monitor the condition of the baby with the help of CTG. In preterm labor, complications often arise: weakness, discoordination of labor, excessive labor that leads to fast and rapid delivery, prenatal or early amniotic fluid, bleeding. A premature baby is most at risk during prolonged labor. Therefore, timely diagnosis and treatment of the weakness of labor activity. For this purpose, prescribed drugs that enhance the contraction of the uterus. They are administered intravenously under careful cardiac monitoring. In the case of excessive labor, drugs are used to reduce the contractile activity of the uterus. It is necessary to prevent intrauterine hypoxia of the fetus with the help of special preparations that improve uteroplacental blood flow.

During attempts, the baby may be injured, so this period requires special care. To reduce the resistance of the pelvic floor muscles, a perineal incision is made.

When do you need a cesarean section?

Cesarean section for preterm labor is done only according to strict indications: when placenta previa (when the placenta blocks the exit from the uterus), premature detachment of the normally located placenta, severe preeclampsia, abnormal fetal position, acute oxygen starvation of the baby.

Premature newborn

Babies born as a result of preterm birth are considered to be premature newborns. There are 4 degrees of prematurity, depending on the duration of pregnancy and body weight at birth:

  • 1st degree, 35–37 weeks - 2500–2001 g,
  • 2nd degree, 32–34 weeks - 2000–1501 g,
  • 3rd degree, 29–31 weeks - 1500–1000 g,
  • 4th degree, less than 29 weeks - 1000 g or less.

In premature infants, there is a decrease in sucking and swallowing reflexes, muscle tone, lethargy, drowsiness, and poor thermoregulation. Due to the immaturity of the baby's lungs, respiratory distress syndrome may develop, which requires the provision of serious medical care.

The prognosis for a premature newborn with preterm birth is very individual and depends on the duration of pregnancy. The longer the period, the higher the chances of the crumbs to quickly recover and catch up with their peers. Чем меньше срок, тем больше вероятность развития неврологических осложнений в силу неполноценного развития центральной нервной системы. Однако при современных возможностях акушерства и неонатологии все больше и больше деток, родившихся раньше срока, получают возможность скорейшего выздоровления и полноценного дальнейшего развития.

Когда преждевременные роды – единственный шанс…

With some complications, premature labor is the only chance to preserve the health of the mother and baby. This is premature detachment of the placenta, chronic placental insufficiency (a condition in which, for whatever reason, the placenta does not cope with its function in full), fetal hypotrophy (fetal sizes are lagging behind the proper sizes corresponding to gestation due to insufficient nutrition), hemolytic disease fetus (destruction of red blood cells in severe rhesus conflict), etc.

What to do when threatened with preterm labor? Only without panic

With the appearance of cramping pain in the lower abdomen, the discharge of amniotic fluid, it is urgent to call an ambulance. In no case do not have to wait in the hope that "now everything will pass," because by that you are missing the opportunity to save the pregnancy. It is very important not to panic and not get lost in the unexpected threat of preterm birth. The most important thing - calm down! After calling an ambulance, you can take a sedative (valerian pill or motherwort) and lie on your left side before the doctor arrives. You must take the documents with you (exchange card, passport, birth certificate, medical insurance policy), you can grab a bathrobe and slippers. Anything else you may need will be brought back later by relatives. Do not be nervous - remember that in a stressful situation there is a spasm of blood vessels (including in the uterus, which violates the uteroplacental blood flow), so try to control emotions for the sake of the child.

What is the threat of premature birth?

If the labor activity has come on term 22 weeks to 37 weeks pregnancy, it is premature birth.

Childbirth at 22-28 weeks. The weight of a newborn is 500-1000 grams. A child who has lived in such a case for more than seven days is the reason for determining the birth as very early preterm.

If the fetus died during childbirth or during the first week of life, then we are talking about a spontaneous abortion (late miscarriage).

Births from 29 weeks to 37 weeks. The fruit weighs about 1000-2500 grams. The weight of his body is sufficient for independent life, and the baby’s organs are considered viable (in the absence of developmental abnormalities). The appropriate treatment is carried out.

The immaturity of the central nervous system, endocrine organs, the absence of certain reflexes make such a kid too vulnerable. These children need special, long-term and active care.

But even careful care and medical monitoring do not guarantee that in the future, premature birth will in no way affect the health of a premature baby.

Let's talk about the reasons

  1. Early onset of labor.
  2. Premature rupture of the membranes of the fetus.
  3. Complications of the uterus or fetus.

What can cause preterm labor? There are also some factors that cause threat of preterm birth:

    drug abuse. Any medication should be prescribed only by a doctor.

  • drinking any alcoholic beverages,
  • malnutrition. Zinc helps prevent preterm labor,
  • excessive weight gain pregnant. The weight gain for the entire pregnancy is 12 kg,
  • hormonal imbalance. The use of hormonal drugs will avoid early and late birth,
  • hard physical work standing upright. Any load should be reduced to a minimum. Take frequent breaks and more rest,
  • sex life. In the last months of pregnancy, you can not have much sex, because the active reduction of the uterus during orgasm can lead to the threat of premature birth,
  • infection (sexually transmitted diseases, rubella, inflammation of the reproductive system and urinary tract) is a threat to the fetus and provokes early birth. The body through preterm labor does everything to prevent infection of the child in the womb. In order to reduce the risk of infection, the pregnant woman should take care of condom protection, visit less crowded places, rest more, eat well and visit the doctor regularly,
  • excessive sensitivity of the uterus. This property can activate premature uterine contraction. Careful examination in the 3rd trimester will allow time to prevent preterm birth. In this case, the recommended use of drugs and bed rest to stop the contractions of the uterus,
  • functional insufficiency of cervical pressurewhat it means premature disclosure. This phenomenon can be noticed at inspection at the very beginning of pregnancy. Therefore, at about 14 weeks pregnant, circumferential sutures are placed on the neck,
  • placenta previa. Due to its improper location, bleeding can occur in 2 or 3 trimester. The position of the child's seat can be investigated using ultrasonography. It is low, close or located above the internal opening of the cervix. The condition of a pregnant woman can only ease bed rest. It will help and prevent preterm labor,
  • abnormal structure of the uterus. This deficiency can be identified even before fertilization. Surgical intervention will help correct it and prevent future preterm labor,
  • abnormal fetal development, which is detected even in the womb of the mother with the help of special medical research and as a result is corrected,

  • multiple pregnancy. In general, such pregnant women give birth 3 weeks earlier than expected. Prevention of preterm labor: careful custody, bed rest, proper nutrition, activity restriction,
  • chronic disease of pregnant: diabetes, hypertension, kidney or liver disease. Prevention for this case is medical care in combination with bed rest,
  • stressful situations: they should be excluded, although it is not easy to do. Such unpleasant manifestations can be reduced to a minimum due to relaxation techniques, adequate nutrition, equal periods of rest and activity, the solution of psychological problems through a conversation with a qualified specialist,
  • age up to 17 years and over 35 years. At an early age it is important to take care of good nutrition and proper medical support for pregnancy, since the mother is still developing with the child. Studies of various genetic disorders, obstetric problems, medical care, a certain diet, the elimination of stress significantly reduce the risk of preterm birth in adulthood,
  • low level of education or insufficient socio-economic level. In this case, it is important medical observation and nutrition.
  • What you need to know: signs and symptoms

    The harbingers of preterm labor can be considered:

    1. Pain, pressing sensation in the lower back, a change in the nature of pain in this part of the body.
    2. Spasmsas with menses, which may be accompanied by diarrhea, nausea, indigestion.
    3. Squeezing of the pelvic regionwhich gives back to the hips and loins.
    4. Vaginal discharge changesthat become pink-red or brownish and become watery. Cork may also come out of thick mucus. Amniotic fluid often flows.

    What are the consequences?

    For a pregnant woman who has survived a premature birth, they are most often fraught psychological problems. After all, a young mother can blame herself for what happened. Because of this, many suffer from postpartum depression.

    But careful care, attention and love for the baby will help overcome this condition. A weak crumb needs contact with his mother like never before.

    Heavier effects of preterm labor for baby. It is often necessary to connect a premature baby to a camera that performs the functions of the respiratory system. After all children born before 35 weeks unable to breathe normally.

    These babies still poorly developed lungs, they have little surfactants. Their deficiency is compensated for by medication, which allows you to save the majority of premature babies.

    But still, in some cases, without artificial respiration during the month does not do. Sometimes such children have chronic lung diseases due to the immaturity of the lung tissue. Therefore, the doctor prescribes drugs to stimulate the growth of this tissue.

    Also the newborn is connected to the device management of vital organs for tracking respiration, heart rate, blood oxygen saturation, blood pressure. This device prevents heart and respiratory arrhythmia and respiratory arrest.

    When caring for a premature baby another power supply device is used. Initially, it can be administered intravenously. In this way, proteins, fats and carbohydrates that are necessary for normal development enter the body of the infant.

    For this purpose, apply a special technique with the use of certain blood vessels and a pump for a sterile supply of nutritional ingredients.

    The incubator practically replaces the uterus to the premature baby. There the right conditions for it are created, the optimum temperature and humidity are maintained.

    In the future, premature babies often become patients with special needs. Due to chronic lung disease, the tendency to spastic bronchitis, an increased risk of developing asthma, and dyspnea during infection may increase.

    Besides, premature babies are not very mature brain. Too high sensitivity of the nervous tissue arises as a result of mechanical damage. The brain also lacks oxygen. All this subsequently negatively affects the work of the child’s nervous system.

    Tactics of treatment of preterm labor

    Delivery is carried out with monitoring vital functions:

    • control over the state of the pregnant: blood pressure, heart rate, hemoglobin, indicators of the coagulation system and the study of urine catheter diuresis,
    • analysis of the fetus through CTG and ultrasound,
    • treatment of syndrome DIC,
    • anti-shock therapy
    • oxygen inhalation.

    Depending on the specific situation, choose active or conservative and waiting tactics of preterm labor.

    The last view is shown at satisfactory condition of the mother and fetus, the whole fetal bladder, cervical dilatation of 2-4 cm, gestation up to 36 weeks, no signs of infection.

    BUT active tactics are appropriate when regular labor, opening of the membranes, signs of infection, severe extragenital diseases of women, fetal impairment, complications of pregnancy and suspicion of developmental defects in the fetus.

    In this case, childbirth often passes through the birth canal, but emergency cesarean section also occurs.

    With threatening and beginning preterm labor complex treatment to reduce excitability and suppress uterine contractions, increase fetal vital activity and its “maturation”, as well as to eliminate pathological conditions that provoked premature labor.

    Pregnant with the threat of premature delivery bed rest is shown. Electrorelaxation of the uterus, electroanalgesia, acupuncture is appropriate.

    When threatening and beginning labor prescribe sedatives, drugs to reduce uterine contractions, medications for the prevention of respiratory distress syndrome in the newborn.

    If the birth has begun, use the stimulants of the birth process (drugs causing preterm labor). With rapid delivery recommended funds for the inhibition of labor activity.

    What it is?

    Premature are those that occurred earlier than the prescribed deadline, namely, from 22 to 37 weeks (births that occurred before the 22nd week are considered to be miscarriage in the later periods). Such labors can be either artificially caused (for medical reasons, for example, in some diseases of the mother or fetal defects), or spontaneous, that is, they begin suddenly and without any outside intervention.

    Also, preterm labor can be divided into threatening, beginning and also beginning. Those who start can not be stopped, so it is extremely important to detect alarming symptoms in time and seek help. Moreover, today even very premature babies are saved and nursed.

    What causes childbirth to start early?

    What could be the threat of premature birth? We list the possible causes:

    • Cervical insufficiency. With this pathology, the cervix, which should close the exit from the uterus and open only at a certain moment (that is, before the birth), weakens and begins to unfold earlier than necessary. The cervical insufficiency may be congenital, but more often it is the result of a woman’s surgery.
    • Many water. Amniotic fluid is necessary because it surrounds the unborn child and protects it. But if the volume of the amniotic fluid is excessive, then the uterus is strongly stretched and, by inertia, begins to shrink, expelling the fetus before the prescribed time.
    • Infectious or inflammatory diseases of the genital organs. Thus, inflammation can spread to the muscles of the uterus and affect it. And because of this, this body, which should normally stretch, cannot do this and begins to try to return to its normal position, expelling the fetus.
    • The risk of premature birth increases significantly with multiple pregnancies, which is associated with excessive stretching of the uterus.
    • Low location (previa) placenta. In this case, the fetus is so low that the cervix simply cannot restrain it and begins to open prematurely.
    • Hormonal disorders. If the amount of sex hormones responsible for the normal course of pregnancy changes, then the structure of cervical tissues will change, because of which it may unfold ahead of time.
    • The threat of premature birth often occurs in women with pathologies of the uterus, such as the two-horned uterus or saddle, infantilism or cervical hypoplasia.
    • Gestosis is an extremely dangerous condition, accompanied by the development of severe edema and an increase in blood pressure.
    • Chronic or congenital diseases of the expectant mother: heart defects, renal failure, diabetes, hypertension, and so on. In this case, the body, feeling threatened and unable to cope with the loads, will try to get rid of the fetus.
    • Hard work and increased loads can also trigger the onset of labor ahead of time.
    • Rhesus conflict is a condition in which the mother’s blood is incompatible with the blood of the fetus (this happens if a woman has a Rh negative and a future child has a positive one).
    • The negative habits of a pregnant woman, in particular smoking or alcoholism, also have a negative effect.
    • Injuries.
    • Uterine fibroids.
    • Stress.
    • Age (over 40 and under 15-17).

    How to recognize?

    There are warning signs that can reveal the threat of preterm birth:

    • Aching pains in the lumbar region, as well as in the lower abdomen.
    • Squeezing in the pelvic region, spreading in this area, pain in the pubic part.
    • Contractions. Contractions of the uterus can be very painful (but at first the pain is most often not felt), chaotic or permanent and regular.
    • Often there are urges to defecate, which is associated with contractions of the uterus and intestinal walls.
    • Bloody issues. This symptom should alert you, as in the normal selection should be transparent or whitish.
    • If there is a partial or complete rupture of the fetal bladder, water may begin to drain.

    If you find the symptoms listed above, call an ambulance immediately.

    What to do: first aid

    What can a pregnant woman do before the arrival of the doctors? Here is the sequence of actions:

    1. First you need to calm down. It is difficult, but it is important to understand that stress will only aggravate the situation. If you have a plant-based sedative on hand (valerian or motherwort extract), take it.
    2. Take a horizontal position and try not to make unnecessary movements, it is extremely undesirable and dangerous.
    3. If you have “No-shpa”, take two pills, this drug will allow you to relax the muscles of the uterus and avoid hypertonia and the beginning of intense contractions.

    In any case, the arrived doctors will offer you hospitalization, and it is impossible to refuse it. But do not collect things. First, these are unnecessary movements, but they are dangerous. Secondly, if necessary, you will bring everything to your relatives.

    What will the doctors do?

    Under clinical conditions, diagnostics will be carried out, which usually includes an examination on a gynecological chair, an ultrasound examination, and blood and urine tests.

    Examination will assess the condition of the cervix, ultrasound will help examine the uterus and the unborn child, and tests are necessary to determine the composition of blood and urine (some changes are signs of pathologies and ailments), as well as to identify infections.

    Therapy most often includes the following measures:

    1. Почти во всех случаях врачи назначают приём препаратов, снижающих тонус матки и расслабляющих гладкую мускулатуру. К таковым относятся «Гинипрал» и «Папаверин». In the case of a slight tone, you will need to take pills or use rectal suppositories, but sometimes you need injections or intravenous fluids (droppers). If the threat persists, the medication continues until the 37-38th week of pregnancy.
    2. If an infection is detected, antibacterial drugs will be prescribed.
    3. It is often necessary to take sedatives that normalize the psychological state of the expectant mother.
    4. If the cause of the threat of premature birth is cervical insufficiency, then a cervix may be stitched, which can only be removed in the last stages of gestation. Obstetric pessary is sometimes used instead of sutures, which prevents early cervical dilatation.
    5. If doctors evaluate the condition as difficult, they will start preparing the pregnant woman and the unborn child for childbirth. In this case, requires the use of drugs that accelerate the maturation and disclosure of the lung of the fetus, as well as other organs.
    6. If the future mother is allowed to go home from the clinic, she will have to comply with all the requirements of the doctors.

    Danger of preterm birth

    What are dangerous preterm birth? The fetus at such an early date is not yet ready for birth and for life outside the womb of the mother. Some systems and organs have not yet had time to form.

    Often, premature babies are nursed, and yet there is a risk of death, as well as developmental delays and some pathologies. But the qualified help of specialists and the positive attitude of the mother will increase the chances of a crumbs for a normal life.

    How to protect yourself from the threat?

    Prevention of the threat of preterm birth includes the following measures:

    • Monitor your health and on time pass all the necessary examinations.
    • Control your condition.
    • Avoid excessive loads.
    • Do not allow contact with sick people.
    • Lead a healthy lifestyle.

    All future mothers want to wish health and timely delivery.

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