Premature(Preterm) Labor: Treatment & Complications

Medically Reviewed by Dr Sravya, MBBS, MS

Introduction

Premature labor is another name for preterm labor. A baby who is born too soon, or roughly three weeks before its due date, is referred to as a preterm, premature, or “preemie” baby. About 40 weeks are required for fetal development during a typical pregnancy. At 37 weeks or earlier, preterm delivery occurs. Discover cutting-edge premature labor treatment options for a healthier pregnancy journey. There are significant health concerns for both mother and child in a premature or early birth.

Preterm or premature labor refers to labor that begins before 37 weeks of pregnancy. When your body starts getting ready for labor and delivery too early in your pregnancy, it happens. Premature labor is when it begins more than three weeks before your due date. Premature labor treatment is important to prevent or treat premature birth or early birth of babies.

Preterm labor happens when your cervix begins to open as a result of frequent contractions after week 20 and before week 37 of pregnancy. Early or late preterm labor is a subcategory of preterm labor. Premature labor occurs before 33 weeks of pregnancy, and between 34 and 36 weeks of pregnancy, preterm labor occurs.

Premature births make up about 1 in 10 births in the United States. In nations with poorer incomes, the number rises. The most common reason for death in children under the age of five is complications from premature deliveries. Here, in this article, we will see the premature labor treatment & premature labor complications.

In This Article

Why Is Your Risk Increased?

Your risk of premature labour may increase due to a number of reasons. Among them are:

Smoking
Being 40 or older or in your teens, being excessively overweight or underweight before conception, or not receiving enough prenatal care.
Pregnant women who drink or use drugs should avoid doing so.
Having health conditions like diabetes, hypertension, preeclampsia, infection history, problems with blood clotting, or preeclampsia.
Being expecting a child that has specific birth abnormalities.
Having a child through in vitro fertilization.
Having twins or other multiple pregnancies.
A personal or familial history of early work.
Premature pregnancy following childbirth..

Premature Labor Treatment Or Preterm Treatment

Based on the gestational age at when the mother arrives at the hospital, management or premature labour treatment is carried out. If the mother exhibits signs of preterm labour at >34 weeks, she is admitted. With directions for follow-up in 1-2 weeks, she can be returned home. To return if there are any additional signs and symptoms of preterm labour or other pregnancy concerns after being observed if she doesn’t have increasing cervical dilation and effacement, a reactive non-stress test shows fetal well-being, and pregnancy problems have been ruled out, for 4-6 hours.

Hospitalization is given to mothers who exhibit premature labour symptoms and signs at 34 weeks of pregnancy. Tocolytic medications are used to stop labour for up to 48 hours in premature labour with intact membranes.

Tocolytics are normally only taken into account between 22 and 34 weeks of gestation and only in the absence of contraindications.

The groups of these medications include: –

Nifedipine, a calcium channel blocker, is favored because it has fewer negative effects than other medications.
Terbutaline is the most used beta-2 agonist for beta-adrenergic.
Due to the risk of PDA closure, it is safer to provide indomethacin for no more than the recommended 48 hours.
Donors of nitric oxide.
Weaker tocolytic medications-:

(i) The drug Atosiban, an antagonist of the oxytocin-vasopressin receptor, is not accessible in the United States.

(ii) Notably, magnesium sulphate is one of the preterm treatments that is most frequently used. Mothers taking this medicine need to be watched for the following things: Vital signs, magnesium levels, urine production, deep tendon reflexes, and respiratory depression.

(iii) Trinitrate of glyceryl
Preeclampsia with severe symptoms, intrauterine fetal death, deadly fetal anomalies, chorioamnionitis, bleeding, and major maternal heart illness are all contraindications to using tocolytic medications.

Normally, pregnancy cannot be continued long enough to allow for additional intrauterine growth and maturation once the membranes have burst. But the morbidity and mortality of newborn should be reduced by adequate management, which includes the following:

Moving the mother to a facility with cutting-edge obstetric and newborn care facilities
Giving the right medications during childbirth to prevent GBS
Prenatal steroid treatment to the mother to lower fetal mortality and morbidity due to respiratory distress
Ventricular bleeding internally
Enterocolitis with necrosis
PDA (Patent ductus arteriosus)
Magnesium sulphate administration for neuroprotection during preterm labour before 32 weeks

The clinician must examine the patient for amniotic infection, fetal compromise, probable abruption, and whether the cervix is still altering if contractions continue despite sufficient tocolytic medication.

Preterm labor induction may be warranted in specific circumstances. A few instances of this include intra-amniotic infection, fetal growth limitation, oligohydramnios, placental abruption, and elevated blood pressure brought on by pre- or eclampsia. Fetal heart tracings are used in these situations to monitor the fetus in a manner similar to that used for term fetuses. Monitoring has been found to lower infant convulsions and intrapartum mortality. The condition of the patient should also be communicated to the newborn care team so that they can make sure the necessary personnel and equipment are on hand.

It is important to note that delayed cord clamping (DCC) has been found to benefit preterm newborns after birth. DCC is linked to greater baseline hemoglobin concentrations, elevated diastolic blood pressures, increased blood volume in circulation, and a slower pace of resuscitation.

A neonatal intensive care unit (NICU) is frequently required to provide specialized medical treatment to preterm infants. This area of the hospital is specifically for infants who are very ill. Specialists in the care of newborns are known as neonatologists. Some infants spend weeks or months in the NICU.

Preterm newborns frequently need assistance with:

Preterm labour can sometimes end abruptly without giving birth. With the proper premature labour treatment (preterm treatment) or on its own, labour might end.
Your doctor may suggest certain drugs to stop or delay labour if you go into premature labour. This is preterm treatment. Other medicines may aid in preparing the baby for birth and avert some difficulties if those don’t work.

There is no one technique to avoid premature birth, there are things you may take to lower your risk:

When pregnant, stay away from smoke, alcohol, and narcotics.
Consume a nutritious, balanced diet.
Throughout your pregnancy, receive complete prenatal care.
Reduce your level of tension.
Between pregnancies, at least 18 months should pass.

Immediately get in touch with your doctor & take premature labor treatment if you experience any of the following premature labor symptoms:

Premature Labor Complications

1. Obstetric complications :

Due to unknown causes, preterm labour has been linked to an elevated risk for cardiovascular mortality and morbidity, usually years after birth.

2. Complications in Children :

The impaired neurodevelopmental outcome, which includes cognitive impairment, motor deficiencies, cerebral palsy, and vision and hearing loss, is linked to preterm labour and delivery. As gestational age decreases, these hazards rise. Preterm labour is also linked to behavioral problems such as anxiety, depression, autism spectrum disorders, and ADHD.

3. Obstetrical Complications :

These include limited growth, the presence of congenital abnormalities, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of immaturity, and retinopathy of necrosis. The incidence of problems in preterm births has decreased thanks to advances in obstetric and neonatal care. The long-term consequences and impairment have improved with patient-specific education and follow-up. To prevent such complications, prevention of premature birth & premature labour treatment is very important.