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Premature labour and birth – prevention

Around one in every 13 babies is born prematurely, before the 37th week of pregnancy. Learn about the signs of premature labour, treatments and ways of preventing it.

How do I know if I'm experiencing premature labour?

If you go to your doctor or hospital because you think you may be in premature labour, monitors will be placed on your abdomen to measure your baby’s heart rate and record any uterine contractions that you have. The doctor will do a pelvic examination to see if your cervix is dilating.

If you think your waters have broken, or if the doctor sees any fluid coming from the cervix, he or she will take a small sample of fluid to determine whether it is amniotic fluid. If it is, a sample may be sent to a laboratory to determine how mature your baby’s lungs are, or your doctor may choose to perform an amniocentesis, which can provide information about your baby’s lung development.

Your doctor will want to test your urine for infection. You may be asked to provide a urine specimen, or your doctor may put a tiny tube in your bladder, called a catheter, to remove a urine sample. Swabs of your cervix may be sent to a lab to test for infection, such as the presence of group B streptococcal bacteria.

What are the treatments for premature labour?

If you get to the hospital early enough, your doctor may be able to stop labour from progressing with hydration, bed-rest, and muscle relaxants or other drugs, which may require hospitalisation. The aim is to allow the baby’s lungs and other organs more time to develop and reach maturity. If doctors can prevent delivery for even a little while, the mother can be given steroids to speed up the baby’s lung development.

If your doctor determines that you are in premature labour, you may be admitted to hospital. You’ll probably be given intravenous fluids through a needle in your arm and treated with one of several drugs, called tocolytics, to try to stop the contractions. You may be given an antibiotic prophylactically, even if you have no obvious infection. Also, you’ll usually be given steroid medications to speed up your baby’s lung development.

If your contractions are successfully stopped, you may be sent home, sometimes with an oral medication. You’ll probably be asked to reduce your activity level, or even to stay in bed, until you get closer to your due date.

In other cases, your doctor may advise an early delivery of your baby rather than trying to stop labour. This choice is usually made when the mother is suffering from an infection of the amniotic fluid and uterus, or has conditions such as severe pre-eclampsia or eclampsia - forms of high blood pressure that occur during pregnancy.

Delivering the baby prematurely may also be preferable if evaluation shows that the foetus is in distress, if you have placenta praevia (a placenta covering the cervix) that bleeds a lot, if you have placental abruption (detachment of the placenta), or if certain birth defects or malformations are identified.

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