Information From Your Health Care Provider

PREMATURE LABOR & PREMATURE BIRTH

Basic information

description

Premature labor is labor that begins before the 37th week of pregnancy. Full-term pregnancy is about 40 weeks. Premature birth may follow premature labor.

FREQUENT SIGNS & SYMPTOMS

Uterine contractions at regular intervals that begin before the 37th week of gestation.
Passage of mucus (may be bloody).
A feeling of pelvic pressure; low back pain; cramping.
May have flow of fluid (amniotic fluid) from the uterus (can be a gush or a steady watery discharge).
Some degree of vaginal bleeding or spotting.

causes

In most cases, the exact problems that cause premature labor are not well-known. Many obstetric, medical, and anatomic disorders are factors for premature labor.

risk increases with

Premature rupture of membranes ("water breaks").
Pregnant with twins, triplets, or more.
Illness of the mother, including preeclampsia, high blood pressure, or diabetes.
Abnormal shape or size of the uterus; weak cervix.
Problems of the placenta, such as placenta previa.
Excessive amniotic fluid (polyhydramnios).
Poor nutrition (more so if it occurs with weight loss).
Previous premature labor or premature birth.
Smoking, excess alcohol use, or drug abuse.
Infection, such as in urinary tract or amniotic fluid.
Mother-to-be is under age 18 or older than 35.
Underweight or overweight before pregnancy. Too little or too much weight gain during pregnancy.
Poor prenatal care or none at all.
Low income, nonwhite racial groups, emotional stress, or certain work (e.g., standing for hours).
Less than 6 months between pregnancies.
In vitro fertilization (IVF).

PREVENTIVE MEASURES

Obtain good prenatal care throughout pregnancy.
Don't smoke, abuse drugs, or drink alcohol.
Eat a well-balanced diet during pregnancy. Take prescribed prenatal vitamins. Use good dental hygiene.
Don't use drugs of any kind, including nonprescription drugs, without medical advice.
Follow medical advice about physical activity levels and sexual activity during pregnancy.
Keep control of any chronic health conditions such as diabetes or high blood pressure. Try to control stress.
Premature contractions can sometimes be stopped by drinking extra fluids (e.g., 16 ounces of water or juice) and then lying down for an hour on your left side.

expected outcomes

In about 50% of cases, the premature labor ceases, either on its own or with treatment.
In some cases delivery must proceed; sometimes by cesarean section. Outcome depends on fetal maturity.

possible complications

Premature infant (may need extensive medical care).
Uterine infection after delivery.
Fetal death.

diagnosis & treatment

general measures

Medical tests usually include a pelvic exam. Lab tests of blood, urine, and fetal fibronectin (a protein secreted by the cervix) are often done. Ultrasound can be used to determine fetal weight, age, growth, and position. An amniocentesis can help determine baby's maturity or diagnose infection. Fetal monitoring may be done.
Treatment depends on the number of weeks of pregnancy, any health problems diagnosed, fetal maturity, and if the cervix has opened (dilated) or begun to thin (efface). Hospital care may be needed. You may be sent home if labor stops or you are not really in labor.
Labor is usually allowed to continue if near term or there is a serious medical problem for mother or baby. A cesarean delivery may be needed.
Labor can often be stopped with treatment. This allows more time for the fetus to mature. Treatment may continue until the 36th or 37th week of pregnancy when there is less risk for the baby.

medications

Drugs to temporarily stop the labor may be given.
Antibiotics may be used to treat or prevent infection.
Corticosteroids may be used to aid fetal lung maturity.

activity

Activity limits and extra rest may be recommended.

diet

Diet limits will depend on treatment.

notify our office if

You or a family member has symptoms of premature labor. Call immediately. This can be an emergency.