Preventing |premature birth

If a doctor can prolong the pregnancy by even a week, it can significantly increase the chance of saving the newborn. After the completion of 26 weeks, each day the pregnancy is prolonged can reduce the risk of death by two per cent. 

A baby born before 37 weeks gestation is premature. While most women safely deliver their newborns after the pregnancy reaches full term, others are more at risk of giving birth prematurely. They include mothers over the age of 35 or under 18, one who is carrying multiple babies as well as women who smoke, drink or have a poor diet.

But every mother-to-be needs to understand that that sometimes, no matter how carefully she is monitored and follows instructions, she may go into premature labour.

The exact cause of pre-term labour is still largely unknown. Medical science doesn't completely understand why some women go into labour or break their water early. 

However, in terms of the predictors of pre-term birth, past obstetric history offer one of the strongest signs. The risk of recurrent pre-term birth after 1, 2, and 3 consecutive pre-term births increases to approximately 15 per cent, 30 per cent, and 45 per cent, respectively. Other significant reasons for pre-term birth are an infection, carrying multiple babies, an abnormally short cervix or a combination of these or more factors.

While every high-risk case demands its own treatment and care, the mother will be recommended to take special care of herself, eat well, get plenty of rest, manage her stress level, start her prenatal care early and see her practitioner regularly. Progesterone may be prescribed to prolong the pregnancy. The progesterone hormone made in the body helps a woman become and stay pregnant. Taking extra natural or synthetic progesterone weekly, starting at 16 to 20 weeks and continuing through 36 weeks, has proven to significantly reduce the risk of a pre-term delivery, particularly for women who had a pre-term birth in the previous pregnancy as well as women with a short cervix.

Progestogen can be given as a gel, cream, capsule, as a shot in the arm or other muscles or as a suppository placed in your vagina.

As the delivery date gets closer, the mother should tune into the changes that are happening in her body. Knowing the symptoms and avoiding particular risk factors allows a mum-to-be to reduce her chance of going into labour prematurely. Pay attention to any unusual aches or pressures. A doctor should be alerted in case of a watery or blood-tinged vaginal discharge. Abdominal pain, cramps, more than four contractions in an hour, pressure in the pelvic area, are also symptoms of premature labour, and even they do not hurt, the doctor should be immediately informed.

While waiting for the doctor, empty the bladder, drink several glasses of water and lie down tilted towards the left side to slow down or stop signs and symptoms.

If a woman is found to have pre-term labour and the full 37 weeks have not been reached, antibiotics may be given to lower the risk of possible infections along with a course of corticosteroids to help hasten the baby’s lung development, which is the last organ to mature. Some women with premature labour and early dilation of the cervix are put on bed rest until the pregnancy progresses.

If none of that works, and if premature delivery is necessary, the newborn will go straight into a neonatal intensive care unit and be put in an incubator as this environment keeps the baby's temperature stable and also decreases the risk of an infection. The humidity is also controlled to maintain the baby’s hydration. There will likely be tubes and wires attached to the baby but it is only to monitor the breathing, heart rate, blood pressure, and temperature constantly. Some babies are fed intravenously through a vein initially, depending on how premature they are before they can be given breast milk.

 

For more information, contact Samitivej Sukhumvit Hospital’s Women’s Health Centre at (02) 711 8555-6 and (02) 2711-8181.