Robert Wood Johnson University Hospital
 

Preterm Labor

High-Risk Pregnancy - Preterm Labor

What is preterm labor?

Preterm labor is labor that begins before 37 completed weeks of pregnancy. Although the exact definitions may vary, preterm labor may include one, or more, of the following:

Nearly 13 percent of all babies born are preterm.

What causes preterm labor?

Many factors can contribute to preterm labor. Although the exact cause of preterm labor is unknown in many cases, one major cause is premature rupture of membranes (breaking of the amniotic sac). Other related factors include the following:

Why is preterm labor a concern?

Preterm birth is the greatest problem associated with preterm labor. Although most babies are born after 37 weeks, those born preterm are at increased risks for many complications.

According to the National Center for Health Statistics, about 13 percent of babies born in the US are born preterm, or before 37 completed weeks of pregnancy. Of all babies:

Premature babies are born before their bodies and organ systems have completely matured. These babies are often small, with low birthweight (less than 2,500 grams or 5.5 pounds), and they may need help breathing, eating, fighting infection, and staying warm. Very premature babies, those born before 28 weeks, are especially vulnerable. Many of their organs may not be ready for life outside the mother's uterus and may be too immature to function well.

Some of the problems premature babies may experience include:

Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long lasting are the health problems.

Other problems associated with preterm labor include complications of the treatment. Medications used to treat preterm labor may have risks for the mother and fetus.

What are the symptoms of preterm labor?

The following are the most common symptoms of preterm labor. However, each woman may experience symptoms differently. Symptoms may include:

If you notice any symptoms of preterm labor, be sure to call your physician as soon as possible.

The symptoms of preterm labor may resemble other medical conditions. Always consult your physician for a diagnosis.

How is preterm labor diagnosed?

If preterm labor is suspected, most women are evaluated in the labor and delivery area of the hospital. Usually, an electronic monitor is used to check the frequency, duration, and strength of contractions. This monitor has a transducer that is placed over your abdomen with a belt. The contractions are transmitted and recorded by the monitor. The fetal heart rate may also be monitored at this time.

Other ways of assessing preterm labor may include the following:

Treatment for preterm labor:

Specific treatment for preterm labor will be determined by your physician based on:

Treatment for preterm labor may include:

Prevention of prematurity:

Because of the tremendous advances in the care of sick and premature babies, more and more babies are surviving despite being born early and being very small. However, prevention of early birth is the best way of promoting good health for babies.

Prenatal care is a key factor in preventing preterm births and low birthweight babies. At prenatal visits, the health of both mother and fetus can be checked. Because maternal nutrition and weight gain are linked with fetal weight gain and birthweight, eating a healthy diet and gaining weight in pregnancy are essential. Prenatal care is also important in identifying problems and lifestyles that can increase the risks for preterm labor and birth. Some ways to help prevent prematurity and to provide the best care for premature babies may include the following:

Some women at high risk for preterm birth may be candidates for treatment with the hormone progesterone. This hormone and its derivative, 17-alpha hydroxyprogesterone, are naturally produced by the placenta during pregnancy. Recent studies have shown that progesterone supplements help reduce the risk for preterm birth in women who had a previous spontaneous preterm birth. More research is needed for this and other ways to help reduce the incidence of prematurity.

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