Let’s first understand what is preterm labor? Preterm birth refers to the birth of a baby between 28 weeks and less than 37 weeks of gestation. Premature babies are called preterm babies and weigh about 1000-2499 g. The smaller the week of gestation and the lighter the weight, the worse the prognosis.
Yesterday, someone I know well called me and asked me what to do when she was hospitalized for preterm labor at 29 weeks of gestation. Because she was a second child, she had no problem delivering her baby, but the baby needed to be sent to the NICU for resuscitation and treatment. In the end, the baby was born at only 1000g, and it was hard to tell if the baby would survive, and the cost was very high. In the end, the family discussed and gave up the treatment.
The incidence of preterm birth is 5-10% of all births. About 1/3 of babies who die within 1 year of birth are born prematurely. With the improvement of medical treatment, the survival rate of preterm babies has improved significantly, and some countries have defined the lower limit of preterm birth as 24 weeks or even 20 weeks of gestation. But the cost can be in the hundreds to hundreds of thousands of dollars, and survival is not always possible.
Causes of preterm labor
1. Premature labor may be caused by too much or too little amniotic fluid, multiple pregnancy, fetal malformation, premature rupture of membranes, etc.
2, malnutrition during pregnancy, high intensity labor or excessive physical exertion, intrauterine infection, uterine malformation, bacterial vaginosis, excessive expansion of the uterus, cervical insufficiency, etc.
3, trauma, impact on the abdomen, mood swings, smoking, alcohol and other bad lifestyles, violent sexual life, etc. can also lead to preterm labor, these parents need to pay attention to.
Clinical manifestations of preterm labor
1, uterine contractions, manifested as paroxysmal abdominal pain, beginning with irregular abdominal pain, abdominal pain once in a few hours, lasting a few seconds, later abdominal pain interval is getting shorter and shorter, while the duration is getting longer and longer.
2.It may be accompanied by a little vaginal bleeding or bloody discharge.
3.Some manifest as vaginal water, that is, premature rupture of fetal membranes.
4.The doctor examines the shortening of the cervical canal and dilatation of the uterine opening.
What to do
If you have any of the above symptoms, you should go to the hospital as soon as possible. In principle, if there is no premature rupture of membranes, try to keep the fetus until 34 weeks and above if the condition of mother and fetus allows.
1.Bed rest.
2.Treatment to promote fetal lung maturation.
3.Treatment to suppress contractions.
(1) β-adrenergic receptor agonist: common drug ritodrine, can be sedative and oral.
(2) magnesium sulphate: intravenous.
4.Control infection: do bacteriological examination of vaginal secretion, and choose antibiotics that are safe for fetus according to drug sensitivity. For premature rupture of membranes, antibiotics must be used prophylactically.
If you have abdominal pain, vaginal bleeding or vaginal water, you should be highly alert to preterm labor and seek medical attention in time.