Pregnancy monitoring prevents premature births | APN messages
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Pregnancy monitoring prevents premature birth
Published on November 17, 2021
From Dr. M Niharika, fertility medicine consultant, Kamineni Fertility Center
November is the national month of awareness for premature babies. Pregnancy usually lasts around 40 weeks. Some risk factors for premature birth include premature birth and multiple pregnancy. Complications associated with premature birth include immature lungs, difficulty regulating body temperature, poor diet, and slow weight gain.
15 million babies are born prematurely each year – that’s more than 1 in 10 babies in the world. Preterm birth has also been linked to behavioral phenotypes and personality profiles that include being shy, socially withdrawn, over-controlled, and averse to risk-taking or fun addiction. Premature birth can also affect the gonadal axis of the pituitary gland in the ovaries or testes, which can lead to reproductive failure.
Early labor is labor that begins before the 37th week of pregnancy. A premature birth does not automatically mean that a woman has a premature birth. The diagnosis of preterm labor is made by the signs and symptoms that the patient exhibits. These include:
- Slight stomach cramps, with or without diarrhea
- A change in the type of vaginal discharge – watery, bloody, or covered in mucus
- An increase in the amount of discharge
- Pelvic or lower abdominal pressure
- Constant, low, dull back pain
- Regular or frequent labor or uterine constriction, often painless
- Broken membranes (your water breaks with a gush or trickle of liquid)
- Only 3 out of 10 women will go into premature labor on their own; the rest must be recognized and treated early on
Early labor can happen to anyone without warning. However, there are a few factors that can increase your risk of premature labor, including:
- Premature birth in a past pregnancy
- Have a short cervix early in pregnancy
- Previous gynecological illnesses or surgeries
- Current pregnancy complications
- Lifestyle factors
Tests to diagnose preterm labor include a pelvic exam to assess the status of the cervix, ultrasound, and a vaginal smear to test for the presence of fetal fibronectin.
Treatment depends mainly on the gestational age of the pregnancy. If the fetus would benefit from delayed delivery, drugs can be given to:
- Help the fetal lungs mature faster
- Reduce the risk of certain complications
- Try to delay delivery for a short time
Medications that will help prepare a fetus for premature birth include corticosteroids, magnesium sulfate, and tocolytics. Corticosteroids can help speed up the development of the fetus’ lungs, brain, and digestive organs. Single treatment with corticosteroids may be recommended between the 24th and 34th week of pregnancy for women who are at risk of delivery within 7 days, including women with ruptured membranes and women who are carrying more than one fetus. If given before a premature birth of less than 32 weeks and planned delivery within 24 hours, magnesium sulfate can reduce the risk of cerebral palsy and movement problems. Tokolytics are drugs that are used to delay labor, sometimes for up to 48 hours.
Prevention of premature births can be achieved through frequent and close monitoring of pregnancy, progesterone support and, in indicated cases, cervical cerclage.