General information on premature labour
What is premature labour?
A normal pregnancy usually lasts about 40 weeks. Your Estimated due date (EDD) is at 40 weeks of pregnancy. However, approximately 10% of women go into labour less than 37 weeks and this is called as premature labour.
Who is at risk of premature labour?
- Women carrying twins or more
- History of previous premature labour
- Abnormal uterus (womb) or cervix
- Vaginal infections e.g bacterial vaginosis, chlamydia, gonorrhoea, Group B streptococcus. (GBS)
- Excessive liquor (polyhydramnios)
- Poor weight gain during pregnancy or underweight prior to being pregnant
- Excessive alcohol consumption or cigarette smoking
- Maternal age < 17 or > 35 years old
- Medical problem e.g diabetes, kidney problem or high blood pressure. Your doctor may induce your labour earlier if there is worsening of your medical condition.
What are the symptoms or signs of premature labour?
- Contraction occurring every 10 minutes or so.
- Watery fluid coming down from your vagina (means your water bag has broken) Medical term for this condition is called leaking liquor.
- Excessive vaginal discharge or change in the colour or smell of the vaginal discharge (may indicate infection)
- Menstrual like cramps in your lower abdomen
- Lower back pain that comes and goes
If you have any of the symptoms above, please go and see your doctor.
How does a contraction feel like?
When your uterus contracts, you could feel your abdomen becomes hard and as the uterus relaxes, your abdomen becomes soft. Contractions tend to be painful compared to Braxton-Hicks contractions. The latter, tends to occur throughout pregnancy but tends to be irregular and painless. It does not cause premature labour.
Is there a test that I could do to know whether I will go into premature labour?
This test if usually done if you are having premature contractions and is called Actum Partus. This is done by doing a vaginal inspection and taking a swab from the cervix. If the test is positive, there is a high chance that you will go into early labour.
What is the treatment for premature contractions?
Firstly, your doctor will find out what is the cause of premature contractions. Majority of the time it is due to some underlying infections (urine or vaginal infections) Treatment for the infections will be given. In addition, there are medications that could be given to suppress the uterine contractions e.g nifedepine, atosiban or hydralazine. This may be associated with some side effects. Corticosteroids in the form of intramuscular injections will also be given to you to fasten your baby’s lung maturation just in case you go into premature labour. You also may need to be transferred to an appropriate hospital with paediatric back up and ventilator (breathing machine) for your premature baby.
What are the complications associated with premature labour?
This depends on how far along you are in pregnancy. Premature babies tend to have problems with breathing, digestive, brain development and prone to infections. If the baby survives, they may still have long term complications. If you go into premature labour prior to 24 weeks, your baby has very little chance of survival as the lungs are still very underdeveloped. Usually babies above 32 weeks do well and do not have long term complications.
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