Preterm Birth – What It Is, Symptoms, and Treatment

Preterm birth occurs when labor begins before the 37th week of pregnancy. Early detection and timely medical care are crucial for the health of both mother and baby.

What is Preterm Birth?
A typical pregnancy lasts about 40 weeks. Preterm birth is when labor starts before 37 weeks of gestation. Early contractions do not necessarily mean preterm labor will occur. However, if signs of preterm labor appear, immediate medical attention is required.

Why is Preterm Birth Risky?
Preterm infants are at higher risk for serious health problems. Some conditions, such as cerebral palsy, are lifelong and irreversible. Other issues, like developmental delays, may appear later in childhood or adolescence.

Can Preterm Labor Stop on Its Own?
In some cases, yes. About 3 in 10 women experience spontaneous cessation of early labor. If it does not stop, medications may be used to delay labor, reducing the risk of complications for the baby.

Signs of Preterm Labor:

• Moderate abdominal cramps, with or without diarrhea;

• Changes in vaginal discharge – watery, bloody, or mucous;

• Increased volume of vaginal discharge;

• Pressure in the lower abdomen or pelvic region;

• Persistent lower back pain;

• Regular or frequent contractions (sometimes painless);

• Rupture of membranes – leakage of amniotic fluid.

Risk Factors:

• Previous preterm birth;

• Shortened cervical length early in pregnancy;

• Past gynecologic pathology or surgery;

• Complications of current pregnancy, such as multiple gestation or vaginal bleeding;

• Lifestyle factors: smoking, poor nutrition, low pre-pregnancy weight;

• Maternal age <17 or >35 years.

Diagnosis:
Preterm birth is diagnosed when contractions occur and cervical changes are detected. Repeated examinations may be necessary over several hours to monitor progression.

Examination Methods:

• Ultrasound to determine gestational age and fetal size;

• Transvaginal ultrasound to measure cervical length;

• Vaginal swab for fetal fibronectin – a protein that helps maintain the amniotic sac.

Medical Treatment:

• Corticosteroids: accelerate lung, brain, and gastrointestinal development of the fetus;

• Magnesium sulfate: reduces risk of cerebral palsy;

• Tocolytics: delay labor for up to 48 hours, allowing time for therapy and transfer to a specialized facility.

Preventing Preterm Birth:

• Vaginal progesterone for cervical shortening before 24 weeks;

• Cerclage – surgical reinforcement of the cervix for women with previous preterm births.

Conclusion:
If labor cannot be stopped, the baby receives specialized care in the neonatal intensive care unit. Women with a history of preterm birth have a higher risk in future pregnancies, making early diagnosis and monitoring critical.