| Basic Information |
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| Description |
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Labor that begins before the 37th week of pregnancy. Premature
birth frequently follows premature labor.
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| Frequent Signs and Symptoms |
- Uterine contractions at regular intervals that begin
before the fetus is mature, usually before the due date of
delivery.
- Passage of bloody mucus (sometimes).
- A sensation of pelvic pressure.
- Flow of fluid (amniotic fluid) from the uterus (sometimes). This may occur with a gush or may be only a continuous watery discharge.
- Some degree of vaginal bleeding or spotting.
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| Causes |
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In most cases, the exact mechanisms that cause premature labor
are not well identified. Many obstetric, medical and anatomic
disorders are associated with premature labor.
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| Risk Increases With |
- Premature rupture of the membranes (the "water breaks").
- Illness of the mother, including preeclarnpsia, high
blood pressure or diabetes mellitus.
- Abnormal shape or size of the uterus.
- Weak cervix
- Hormone imbalance.
- Vaginal infection that spreads to the uterus.
- Large fetus or more than one fetus.
- Abnormalities of the placenta, such as placenta previa.
- Excessive amniotic fluid.
- Poor nutrition, especially if associated with weight
loss.
- Previous premature labor.
- Smoking; excess alcohol consumption.
- Injury to the uterus.
- Urinary tract infection, especially kidney infection
(pyelonephritis).
- Use of mind-altering drugs, e.g., narcotics,
psychedelics, hallucinogens, marijuana, sedatives, hypnotics
or cocaine.
- Adolescent mothers
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| Preventive Measure |
- Obtain good prenatal care throughout pregnancy.
- Don't smoke, use mind-altering drugs or drink alcohol
during pregnancy.
- Eat a normal, well-balanced diet during pregnancy. Take
prescribed prenatal vitamin and mineral supplements.
- Don't use medications of any kind, including nonprescription
drugs, without medical advice.
- If you have a weak cervix, which is sometimes evident before pregnancy,
get medical advice about a minor operation to strengthen the cervix.
- Rest more and decrease activity in the 3rd trimester,
especially if you have blood spotting or irregular contractions.
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| Expected Outcome |
- In about 50% of cases, the premature labor ceases, either with treatment or spontaneously.
- Labor can often be stopped with treatment to allow more time for the fetus to mature. However, if the membranes have ruptured or the placenta has separated from the uterus, labor must proceed sometimes by cesarean section.
The outcome depends on fetal maturity.
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| Possible Complications |
- Premature infant.
- Uterine infection after delivery.
- Fetal death.
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| Treatment/Post Procedure Care |
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| General Measures |
- Diagnostic tests may include amniocentesis to determine
fetal maturity and to check for infection inside the uterus
that could be causing the symptoms. Ultrasound is used to
determine fetal weight, age, growth and position.
Laboratory blood and urine studies on the mother are used
to check for infection.
- Hospitalization and treatment may be necessary for any
underlying risk factors (infections, dehydration).
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| Medication |
- Medication to stop labor include terbutaline, ritodrine and
magnesium; less frequently used are indomethacin and
nifedipine.
- Antibiotics to fight infection, if it develops. Antibiotics
may also be used to help protect the fetus from infection.
- Corticosteroid therapy may be considered to accelerate
fetal lung maturity.
- Sedatives and pain relievers are used if needed.
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| Activity |
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Complete bed rest is necessary once signs of premature
labor begin. Discontinue work or other physical activities.
Avoid any sexual activity.
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| Diet |
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once labor begins, drink only dear liquids until after the delivery.
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| Notify Your Healthcare Provider If |
- You or a family member has symptoms of premature
labor. Call immediately. This is an emergency!
- During pregnancy, you think you have a urinary tract
infection.
- After delivery, you have abdominal pain, drills and fever,
headache, muscle aches or a bad-smelling vaginal discharge.
- New, unexplained symptoms develop. Drugs used in
treatment may produce side effects.
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