Managing Preterm Labour: Strategies for Prevention and Care

Waiting for your baby' arrival fills you up with joy, doesn't it? Seeing your baby after 9 long months of wait is a feeling like none other. But sometimes the wait is shorter than 9 months and that's not something any parent wants. That is what's also known as preterm labour.

As an expectant parent, it's natural to have questions and concerns about the health and well-being of your growing baby. Understanding the risks, signs, and management strategies for preterm labour can help you feel more prepared and empowered during your pregnancy.

In this article, we'll explore the complexities of preterm labour, providing you with valuable insights and guidance to support you every step of the way.

Preterm labour is a serious concern for many expectant parents, as it can lead to the birth of a premature baby who may face various health challenges. By understanding preterm labour better, you can take proactive steps to minimise your risk and ensure the best possible outcomes for you and your little one.

Definition and Prevalence

Preterm labour refers to the onset of regular uterine contractions that cause progressive changes in the cervix before 37 completed weeks of gestation. These contractions can lead to the birth of a preterm baby, which is a significant contributor to infant mortality and morbidity worldwide.

According to a study published in the Lancet Journal, India accounted for over 20% of all preterm births in 2020 with over 30 lakh early births. Prematurity and low birth weight are closely linked, as babies born before 37 weeks may not have had sufficient time to grow and develop fully in the womb. The earlier a baby is born, the higher the risk of complications, making the prevention and management of preterm labour a critical aspect of prenatal care.

Several factors can increase the likelihood of preterm labour, including previous preterm births, multiple pregnancies, and certain medical and lifestyle conditions. Women who have experienced preterm labour in the past are at a higher risk for subsequent preterm deliveries. Understanding these risk factors is crucial for managing and preventing premature birth.

Medical Conditions

• Chronic hypertension and gestational diabetes: These conditions must be closely monitored and managed to minimise the risk of preterm labour.
• Systemic lupus erythematosus: Autoimmune disorders can increase the likelihood of preterm labour.
• Urinary and genital tract infections: While treating these infections may not necessarily reduce the risk, they can trigger preterm labour.
• Periodontal disease: Although treatment has not been shown to lower the risk, periodontal disease is associated with an increased likelihood of preterm labour.
• Cervical abnormalities: A shortened cervix or previous cervical surgeries can elevate the risk of preterm labour.

Lifestyle Factors

• Smoking: Smoking during pregnancy is associated with a higher risk of preterm labour and other health complications for both the mother and the preterm baby.
• Substance abuse: The use of recreational drugs increases the likelihood of premature birth and can lead to prematurity and low birth weight.
• Chronic stress: High levels of stress can contribute to the risk of preterm labour and may impact baby growth.
• Poor nutrition and hydration: Inadequate nutrition and dehydration can trigger contractions and increase the risk of preterm labour.
• Short pregnancy interval: Less than 18 months between pregnancies can elevate the likelihood of preterm labour.

Recognising and addressing these risk factors is essential for the effective management of preterm labour and the prevention of preterm labour.

Recognising the symptoms of preterm labour is crucial for timely intervention and management of preterm labour. However, these symptoms can be subtle and may resemble normal pregnancy discomforts, making them easy to overlook. Common symptoms include:

• Regular or frequent contractions, often accompanied by a sensation of pelvic pressure
• Dull, low backache that may be constant or intermittent
• Abdominal cramps, similar to menstrual cramps
• Vaginal discharge that may be watery, mucus-like, or bloody
• A feeling of pelvic pressure or heaviness

If you experience any of these symptoms, it is essential to contact your healthcare provider immediately for prompt evaluation and appropriate management of preterm labour.

Preterm birth can lead to various serious health complications for the baby. Some of the key complications include:

• Breathing problems: Premature babies often have underdeveloped lungs, which can result in respiratory distress syndrome, apnea, and bronchopulmonary dysplasia (BPD).
• Heart issues: Conditions such as patent ductus arteriosus (PDA) and low blood pressure are common in preterm babies.
• Brain bleeding: Intraventricular haemorrhage, which can cause permanent brain injury, is more likely in earlier preterm births.
• Temperature regulation difficulties: Premature babies can quickly lose body heat, leading to hypothermia.
• Immune system deficiencies: An underdeveloped immune system increases the risk of infections and sepsis.
• Long-term health concerns: Cerebral palsy, learning disabilities, behavioural problems, asthma, dental issues, hearing loss, and vision problems like retinopathy of prematurity are potential long-term complications.
• Developmental delays: Preterm babies may experience delayed physical, intellectual, and emotional development.

These complications underscore the importance of implementing effective strategies to prevent preterm labour and provide appropriate care for premature babies.

While not all cases of preterm labour can be prevented, several strategies can help reduce the risk and improve outcomes for both mother and baby.

Regular Prenatal Check-ups

Regular prenatal care plays a crucial role in preventing and managing preterm labour:

• Monitoring maternal and fetal health: Regular check-ups allow healthcare providers to closely monitor the well-being of both the mother and the baby.
• Early identification of risk factors: Prenatal visits help detect and address risk factors such as previous preterm labour, multiple pregnancies, gestational diabetes, or chronic conditions early in the pregnancy.
• Increased frequency for high-risk pregnancies: Women with a history of preterm labour or other risk factors may require more frequent prenatal visits for closer monitoring.
• Guidance on healthy practices: Healthcare providers offer advice on maintaining a balanced diet, avoiding harmful substances, and managing stress to promote a healthy pregnancy.

Lifestyle Modifications

In addition to regular prenatal check-ups, making lifestyle changes can further reduce the risk of preterm labour:

• Maintaining a healthy weight: Preterm labour is associated with both low birth weight and obesity. Achieving a healthy pre-pregnancy weight and gaining weight appropriately during pregnancy can lower the risk.
• Eating a balanced diet: A diet rich in fruits, vegetables, whole grains, and lean proteins provides essential nutrients for fetal development and helps prevent complications like gestational diabetes.
• Avoiding harmful substances: Abstaining from smoking, alcohol, and illicit drugs is crucial, as these substances can increase the risk of preterm labour and other pregnancy complications.
• Managing stress: High levels of stress have been linked to an increased risk of preterm labour. Engaging in stress-reducing activities like prenatal yoga, meditation, or seeking support from loved ones can help manage stress during pregnancy.

Managing preterm labour involves a multifaceted approach that combines medical interventions and lifestyle modifications to delay or prevent early birth.

These strategies, when implemented effectively, can significantly reduce the incidence of preterm labour and improve outcomes for both mother and baby.