Preterm Labour

Bringing a new life into the world is a delicate process, and timing is crucial. While a normal pregnancy lasts about 40 weeks, sometimes labour can begin too early—before 37 weeks of gestation. This is known as preterm labour or premature labour, and it can lead to the birth of a preterm baby.

Preterm labour is a serious obstetric condition that requires immediate medical attention. Early identification of symptoms and prompt intervention can significantly improve the outcomes for both the baby and the mother. This blog explains everything you need to know about preterm labour, including signs and symptoms, causes, risk factors, diagnostic options, and treatment strategies.

What is Preterm Labour?

Preterm labour refers to uterine contractions that begin before 37 completed weeks of pregnancy and lead to changes in the cervix such as dilation or effacement (thinning). If not managed appropriately, preterm labour may result in preterm birth, which is one of the leading causes of neonatal morbidity and mortality worldwide.

Categories of Preterm Birth

Preterm births are classified by gestational age:

• Extremely preterm: Less than 28 weeks

• Very preterm: 28 to 32 weeks

• Moderate to late preterm: 32 to 37 weeks

The earlier the birth, the higher the risk of complications for the baby.

Signs and Symptoms of Preterm Labour

Recognizing the early signs of preterm labour can save lives. According to the informative image from Sparsh Diagnostic Centre, the symptoms include:

• Regular or frequent contractions (more than 4–6 per hour)

• Constant lower back pain or pressure

• Lower abdominal or pelvic pressure

• Light bleeding or vaginal spotting

• Mild abdominal cramps, with or without diarrhea

• Change in vaginal discharge (watery, bloody, or mucus-like)

• Preterm rupture of membranes (water breaking early)

• Persistent menstrual-like cramps

• Leaking of fluid from the vagina (suggesting loss of amniotic fluid)

⚠️ If any of these symptoms occur, it’s critical to contact your healthcare provider immediately or visit a diagnostic centre.

Causes of Preterm Labour

While in many cases the exact cause of preterm labour is unknown, several factors can trigger early contractions and cervical changes. These include:

1. Infections

• Urinary tract infections (UTIs)

• Bacterial vaginosis

• Sexually transmitted infections (STIs)

• Intra-amniotic infections

2. Uterine or Cervical Abnormalities

• Short cervix

• Incompetent cervix

• Fibroids or uterine malformations

3. Multiple Pregnancies

• Carrying twins, triplets, or more increases uterine stretch and the likelihood of early labour.

4. Placental Problems

• Placenta previa or placental abruption can trigger premature labour.

5. Previous Preterm Birth

• A history of preterm delivery is one of the strongest predictors of recurrence.

6. Lifestyle Factors

• Smoking, alcohol or drug use

• Poor nutrition or inadequate weight gain

• High levels of stress

7. Medical Conditions

• High blood pressure (preeclampsia)

• Diabetes

• Polyhydramnios (too much amniotic fluid)

• Gestational infections

Risk Factors for Preterm Labour

Women are more likely to go into preterm labour if they:

• Have had a previous preterm birth

• Are pregnant with multiples

• Have had uterine or cervical surgery

• Have a short cervix (<25mm)

• Are younger than 17 or older than 35

• Experience domestic violence or chronic stress

• Have limited access to prenatal care

Complications of Preterm Labour and Birth

Babies born before 37 weeks are at a higher risk of health issues, particularly if born before 32 weeks. Complications can include:

Short-Term Complications

• Respiratory distress syndrome (RDS)

• Intraventricular hemorrhage (IVH) – bleeding in the brain

• Necrotizing enterocolitis (NEC) – a serious intestinal condition

• Patent ductus arteriosus (PDA) – a heart defect

• Hypothermia due to insufficient body fat

Long-Term Complications

• Developmental delays

• Vision and hearing problems

• Cerebral palsy

• Learning difficulties

• Chronic lung disease

How Is Preterm Labour Diagnosed?

Timely diagnosis can help doctors intervene before full-blown labour begins. Evaluation typically includes:

1. Physical Exam

• Monitoring uterine contractions

• Checking for cervical changes (dilation or effacement)

2. Ultrasound

• Measures cervical length

• Checks for fetal well-being and placental position

3. Fetal Fibronectin Test (fFN)

• A swab test to detect fFN, a protein that increases when preterm labour is imminent.

4. Non-Stress Test (NST) or CTG

• Tracks the baby’s heartbeat and contractions.

5. Urine and Vaginal Swab Tests

• To identify infections that may be causing contractions.

How is Preterm Labour Managed?

If diagnosed early, preterm labour can often be delayed or even stopped. Management strategies depend on gestational age, cause, and symptoms.

1. Hospital Admission

• For close monitoring of the mother and baby.

2. Tocolytic Medications

• Medications like nifedipine or terbutaline are used to stop or slow contractions for 24–48 hours.

3. Corticosteroids

• Administered to accelerate fetal lung maturity (especially between 24–34 weeks).

4. Magnesium Sulfate

• Given to protect the baby’s brain and reduce the risk of cerebral palsy in very preterm deliveries.

5. Antibiotics

• Used to treat underlying infections or prevent neonatal sepsis if membranes have ruptured.

6. Cervical Cerclage

• A surgical stitch in the cervix to prevent it from opening too early (used in cases of cervical insufficiency).

7. Bed Rest and Hydration

• Though controversial, some doctors recommend rest and fluids to reduce contractions.

Preventing Preterm Labour

While not all cases can be prevented, several strategies can significantly reduce the risk:

1. Regular Prenatal Care

Early and consistent care allows for risk identification and early intervention.

2. Healthy Lifestyle

• Avoid tobacco, alcohol, and recreational drugs.

• Maintain a balanced diet rich in iron, calcium, and folic acid.

3. Manage Chronic Conditions

• Keep hypertension, thyroid disorders, and diabetes under control.

4. Treat Infections Promptly

• Report any signs of urinary or vaginal infections.

5. Monitor Cervical Length

• Especially in women with a history of preterm birth.

6. Progesterone Therapy

• Vaginal progesterone or injections can help prevent preterm labour in high-risk women.

What to Do if You Suspect Preterm Labour

If you’re pregnant and notice contractions, pelvic pressure, or vaginal discharge, it’s important to:

• Lie down on your left side.

• Stay hydrated.

• Avoid strenuous activity.

• Call your doctor immediately.

Remember, early intervention can delay delivery and significantly improve the chances of a healthy outcome.

Living with the Risk of Preterm Labour

Some women may be at ongoing risk of preterm labour. In such cases, your healthcare provider may:

• Schedule more frequent prenatal visits

• Recommend pelvic rest (no sex or heavy lifting)

• Advise home uterine monitoring

• Suggest hospitalization if necessary for observation

When Delivery is Inevitable

In some cases, despite all efforts, delivery cannot be prevented. Modern neonatal intensive care units (NICUs) have made significant advancements in caring for premature babies. Key support systems may include:

• Incubators for temperature control

• Mechanical ventilation or CPAP for breathing

• Feeding support via IV or feeding tubes

• Phototherapy for jaundice

• Ongoing neurodevelopmental follow-up

Emotional Impact of Preterm Labour

Preterm labour can be emotionally overwhelming for the parents. Feelings of anxiety, guilt, or fear are common. Support is available through:

• Counseling or therapy

• Peer support groups

• Neonatal care coordinators

• Family education from the hospital team

Preterm labour is a serious but manageable condition. Recognizing the warning signs early, such as frequent contractions, vaginal discharge, or lower abdominal pain, and seeking prompt medical care can drastically reduce complications.

Modern diagnostics, medications, and NICU support mean that even babies born early can thrive with the right care. At Sparsh Diagnostic Centre, we provide comprehensive services for pregnancy monitoring, fetal assessments, ultrasound diagnostics, and early detection of complications.

Takeaway Tip:
Pregnancy is a journey, and every week counts. Stay alert to changes, follow up regularly with your doctor, and trust your instincts. If something doesn’t feel right—act fast.

Visit Sparsh Diagnostic Centre Today

Whether you’re managing a high-risk pregnancy or seeking a routine antenatal check-up, Sparsh Diagnostic Centre is here to help. We offer:

• Obstetric ultrasounds

• Fetal well-being assessments

• Infection screening

• Prenatal counselling

📍 Visit us at Bansdroni, Kolkata
📞 Call: 9830117733 / 8335049501
🕐 Centre Open: Mon to Sat 7 AM – 9 PM | Sunday 7 AM – 3 PM

#BhaloTheko