What causes premature labor and delivery?
1. Stress - Physical or psychological stress activates the Hypothalamic Pituitary axis in the brain. When this is activated, stress hormones are released into the blood circulation and this, in turn, initiates pre-mature labor. Fetal stress like problems with the placenta or with the cord can also cause premature labor.
2. Inflammation and infections like Urinary tract infection, bacterial infections can also induce labor.
3. Placental abruption occurs as a result of bleeding between placenta and uterine wall. In response to this bleeding, uterus begins to contracts and tries to slow down the bleeding but in turn, causes labor
4. Some abnormality in uterine distention - Uterus can get overstretched due to twins, polyhydramnios ( too much amniotic fluid) or any abnormalities with cervix (too thin or soft)
How do we diagnose that women could be in preterm labor?
First and foremost is that the women could start having uterine contractions. The uterus is a muscle, so when it contracts it causes labor. Irregular contractions occur throughout pregnancy which is called Braxton Hicks contractions. But uterine contractions which are more regular more than 6 contractions an hour, painful and frequent and associated with cervical dilatation could be a sign of labor. If fetal membranes are also ruptured along with the uterine contractions, this could indicate true labor.
Transvaginal ultrasound is done to confirm the labor.
How do we treat?
Initially, the women could try to drink a lot of fluid and lie down and see if the contractions stop. but if it does not stop then contact your doctor.
If mom is in preterm labor and is less then 34 weeks in her pregnancy the first step is to administer a dose of steroid, this help in speeding up baby’s lung development. A tocolytic agent (a medication that relaxes the uterus up to 48 hours) is also given. if less then 32 weeks then a dose of Magnesium sulphate is given that has a protective effect on the brain of the fetus. Bed rest is also prescribed. These treatments may not stop preterm labor. But they may help you to stay pregnant longer.
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