Pre-term Labor Dangers Assignment Help
Normally, pregnancy is supposed to last 40 weeks. Most women will go into labor at the 40th week. However, some may go into labor earlier than that. Preterm labor comes with contractions that cause the cervix to open before the 37th week of pregnancy.
Preterm labor often leads to premature birth. Premature birth poses several risks to the baby. Babies born prematurely will need extra care. Sometimes these babies will develop long-term health problems that are likely to affect them throughout their lives.
Babies born earlier in pregnancy have a high chance of developing mental and physical disabilities. It is not known what causes preterm labor. However, several risk factors increase the chances of preterm labor.
Preterm labor can also be described as when the body gets ready for birth too early in the pregnancy. Preterm labor can also be called premature labor. Preterm labor is labor that starts more than three weeks before the due date.
Preterm labor is likely to lead to premature birth. However, this is not always the case because there is a lot that doctors can do to prevent it. The baby should grow inside the womb for as long as possible for them to not develop any problems after birth.
Risk Factors for Preterm Labor
Preterm labor can occur in any woman leading to premature birth. This can happen even if the mother does everything by the books. Some factors make some women more likely to develop preterm labor compared to other women.
Risk factors for preterm labor include:
- history of premature birth
- history of abortion
- problems with the cervix
- multiple gestations (more than one baby in the womb)
- certain genetic conditions
- vaginal bleeding in the middle of the pregnancy
- problems with the uterus
- limited access to prenatal care
- drug and alcohol use
- polyhydramnios (an excessive amount of amniotic fluid)
- Infection – women who experience viral or bacterial infection when pregnant have a higher chance of experiencing preterm labor which can lead to premature birth. Women can develop infections in any part of the reproductive system or the urinary tract. Infections can occur in the kidneys, vagina, uterus, cervix, bladder, and urethra.
In some cases, women can develop infections in the bloodstream. When the body responds to these infections, this can trigger premature labor and lead to premature delivery.
Infections that reach the uterus are the ones that are likely to cause preterm labor. Infections that get to the uterus often trigger chemical reactions. These reactions may trigger the uterus to start contracting.
Infections that cross the membranes surrounding the baby and enter the amniotic cavity are more likely to cause preterm labor. Infections that are more likely to cause preterm labor are bacterial vaginosis, gonorrhea, trichomoniasis, and chlamydia.
- History of premature birth – women who have previously delivered prematurely are more likely to experience premature labor and premature birth in the pregnancies that follow.
However, the likelihood of this happening also depends on how early these premature births occurred and how many they are. Subsequent premature births are likely at the same time as the previous ones or earlier.
This risk applies to women who have spontaneous premature births after premature labor. Women who deliver babies at full term are less likely to experience premature births in the subsequent pregnancies.
- History of abortion – researchers believe that women with a history of abortion are more likely to experience premature labor which leads to premature birth. Those who have had more than one abortion are likely to have premature birth later on in life.
This is believed to be the case because, during an abortion, the cervix might be damaged rendering it incompetent. This means that the cervix is likely to open early in a pregnancy leading to preterm birth.
Unless this issue is addressed by the doctor, it is likely to affect subsequent pregnancies.
- Problems with the cervix – the cervix is the lower part of the uterus and should remain closed when a woman is pregnant. When it is time for labor, the contractions of the uterus cause it to open by softening and shortening.
However, in some cases, the cervix will open before time. This is called cervical insufficiency. Women with this condition are likely to experience preterm labor. Causes of cervical insufficiency include injuries caused by medication, injury, or surgery.
Risk factors for cervical insufficiency include:
- previous operations on the cervix – cone biopsy is done in women whose pap smear appears abnormal. This involves removing a portion of the cervix for examination. This can increase the risk of cervical insufficiency.
- history of trauma to the cervix for example during delivery.
Women with cervical insufficiency should be monitored closely throughout the pregnancy to avoid preterm labor. Cervical cerclage may also be performed to strengthen a weak cervix.
- Multiple gestations – multiple gestations cause the uterus to stretch more with multiple gestations. This puts a woman at risk of preterm labor. If the uterus is stretched so much, it can begin to contract before the babies are fully developed.
The more the number of babies the higher the chance of preterm labor. Multiple gestations also pose several risks to the mother and babies and may cause complications.
These complications may also make preterm labor more difficult to treat and manage. Mothers in such situations need the help of a high-risk obstetrical specialist to prevent severe outcomes.
- Vaginal bleeding in the middle of pregnancy – vaginal bleeding in the middle of the pregnancy poses a risk especially if it occurs between the 12th and 24th week. The seriousness of the bleeding depends on the cause of the bleeding.
The main causes of vaginal bleeding are placental abruption and placenta previa. Placenta previa occurs when the placenta partially or covers the cervix opening. Placental abruption is when the placenta separates from the uterine wall too early.
Women who experience vaginal bleeding at any point should see their doctor for evaluation. Not all cases of vaginal bleeding are a sign of a problem. However, it is good to see the doctor determine the cause.
- Problems with the uterus – common abnormalities of the uterus are;
- an irregularly shaped uterus
- presence of a second and completely formed uterus
- presence of a wall inside the uterus dividing it into two
The risk for preterm labor in women with problems in the uterus depends on the type of the risk. Those with a wall inside the uterus have the lowest risk while those with an abnormally shaped uterus are at the highest risk.
- Polyhydramnios – this is an excess amount of amniotic fluid. This excess fluid causes the uterus to stretch more than usual. If the uterus is overstretched, it begins to contract to lead to preterm labor.
Symptoms of polyhydramnios include difficulty breathing, increased swelling of the feet and legs, an unusually big abdomen for gestational age, and decreased urine output.
To diagnose, the doctor will order an ultrasound to know the amount of amniotic fluid in the uterus. If diagnosed, the doctor removes the excess fluid through amniocentesis. The doctor is guided by the ultrasound to insert a long needle through the abdomen into the amniotic sac and the excess fluid is extracted.
Additionally, the doctor uses the ultrasound to know the cause of polyhydramnios. The long needle can be used to take tissues samples. This helps to know if there is something wrong with the baby, the placenta, or the mother.
Common causes of maternal polyhydramnios are red blood cells incompatibilities and diabetes. It is always important to find out the cause of polyhydramnios because the cause is what increases the risk for preterm labor more than the severity of the condition.
For instance, preterm labor is more likely to occur if polyhydramnios is caused by a defect in the baby.
- Genetic, Economic, and Social Factors
In addition to medical conditions, preterm labor may also be caused by genetic, social, and economic factors.
- Genetics and Race – certain genetic traits that are inherited can increase the possibility of a woman experiencing preterm labor and preterm birth. For instance, African-American women in the United States are more likely to experience preterm labor compared to women of other ethnicities under the same economic and social factors.
It is not clear why this is the case. However, African-American women have higher rates of urinary tract infections and infections affecting the reproductive system. This increases their risk for preterm labor.
- Economic factors – women earning the minimum wage are more likely to experience preterm labor and preterm birth due to lack of prenatal care, shelter, and food. women who cannot get enough nutrition are likely to begin their pregnancy when they are underweight which is an additional risk for premature labor.
Risk for premature labor increases if the mother or father of the baby is not employed and lacks health insurance. This hinders them from accessing quality prenatal care. Stresses that come with unemployment may also increase the risk for preterm labor.
- Social factors – social factors that are likely to affect a woman’s risk for preterm labor are:
- being single
- being over 40 years or under 16 years
- working long hours
- drinking alcohol, smoking, and using recreational drugs while pregnant
- being constantly exposed to pollutants and chemicals
- lack of support from family and friends and community members
- being emotionally or physically abused
Risk factors are not a sure guarantee of preterm labor and preterm birth. However, risk factors increase the likelihood of a woman experiencing preterm labor. Pregnant women need to talk to their doctor early in the pregnancy to help lower the risks of preterm labor.
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Symptoms of Preterm Labor
It is important to know the warning signs of preterm labor to stop it. Fast action/response can help. Pregnant women should call their midwife or doctor if they experience the following:
- Backache at the lower back that comes and goes or is constant and may ease with change in position.
- increased pressure in the vagina or pelvis
- cramping in the lower abdomen or cramping that is similar to menstrual cramps. They may feel like the gas pains associated with diarrhea.
- increased vaginal discharge
- fluid coming out of the vagina
- contractions that occur every ten minutes or more often that usually worsen and become more frequent
- vaginal bleeding including light bleeding
- flu-like symptoms like diarrhea, nausea, and vomiting. Mild cases should not be ignored. Call the doctor if they cannot tolerate liquids for more than 8 hours.
It may be hard to differentiate these symptoms from normal symptoms of pregnancy. However, a pregnant woman should be too cautious and have any warning signs checked by the doctor as soon as possible.
How to check for contractions in preterm labor
One way of spotting preterm labor is checking for contractions. You can check for contractions by:
- placing the fingertips on the abdomen
- If you feel the tightening and contracting of the uterus then that is an indication of a contraction
- Next step would be timing the contractions. Write down the time a contraction starts and the start of the next contraction
- try to stop the contraction by getting off the feet, changing the position, and relaxing. You can also drink 2-3 glasses of water.
- Call the doctor if the contractions continue every 10 minutes or if they get more frequent. If you have severe pain that does not go away you should call the doctor.
Women may also experience harmless false labor known as Braxton Hicks contractions. They are erratic and stop when the woman moves or rests. They are not actual labor pains. Contact your doctor if you are unsure about your contractions.
The doctor may advise that you go to the hospital if they think you’re going into preterm labor. Once at the hospital, the midwife or doctor will:
- ask about the medical history including any medicines you may have taken during pregnancy
- check your temperature, blood pressure, and pulse.
- put a monitor on the belly to check the heartbeat of the baby as well as your contractions.
- swab for fetal fibronectin to help predict the risk of delivering the baby
- test your urine or cervix for infection
- check to see if the cervix is opening
Pregnant women diagnosed with preterm labor will be treated using medicines to relax the uterus and stop labor, iv fluids, antibiotics, and medicine to speed up the development of the baby’s lungs. They may be admitted to the hospital.
If the labor does not stop and cannot be stopped, the midwife or doctor will prepare to deliver the baby. This will also be the case if the amniotic fluid or uterus is infected and if the woman has eclampsia or severe eclampsia.
The doctor may also deliver the baby prematurely if the baby is not doing well for instance if the mother has placenta previa that causes excessive bleeding. They may also deliver the baby if the mother has placental abruption or if malformations or birth defects are found.
If the doctor is sure that you are not experiencing premature labor, they will ask you to go home.
Dangers of Preterm Labor on Babies
Babies should remain in the uterus until the last day to allow them to grow fully. Children born prematurely are not completely developed. Premature birth may cause serious health problems for the baby.
Premature babies often have brain, heart, liver, and lung problems. Common heath problems associated with children born prematurely are:
- bronchopulmonary dysplasia or underdeveloped lungs
- neonatal sepsis or blood infection
- apnea of prematurity or temporary pauses in breathing when sleeping
- retinopathy of prematurity or underdeveloped blood vessels in the eyes
- intraventricular hemorrhage or bleeding in the brain
- patent ductus arteriosus or abnormal flow of blood in the heart
- necrotizing enterocolitis is also known as the inflammation of the intestines.
Babies born prematurely may also develop the following health issues later in life:
- poor growth
- cerebral palsy
- learning disabilities
- hearing and vision problems
Health risks of premature labor/birth on the mother
A baby born prematurely will have an emotional impact on the mother and the family. Women who experience preterm labor are likely to have anxiety, problems bonding with the baby, postpartum depression, and post-traumatic stress disorder.
Preterm labor that leads to premature birth can create health concerns for the baby. Premature birth denies the baby enough time to grow in the womb. This means that the baby is born while some of the important organs are not fully formed.
The good news is that advances have been made in newborn care to help as many premature infants as possible to grow into robust and healthy children. The best way for pregnant women to avoid preterm labor is by staying healthy throughout their pregnancy.
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