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Premature birth corresponds to the birth of the baby before 37 weeks of gestation, which can happen due to uterine infection, premature rupture of the amniotic sac, detachment of the placenta or diseases related to women, such as anemia or pre-eclampsia, for example.
This situation can be perceived through some symptoms such as frequent and regular uterine contractions, increased vaginal discharge and pressure or pain in the pelvic region, for example. It is important that the woman goes to the hospital as soon as she feels these signs and symptoms, since premature labor can represent risks for the baby, since depending on the gestational age the organs can still be very immature, and there may be problems in the heart and difficulty breathing, for example.
Thus, in the case of premature labor, the doctor may try to postpone birth using medications and techniques to prevent uterine contractions and dilation, however, it is difficult to postpone delivery for more than 48 to 72 hours. In the case of the birth of a premature baby, it is common to stay in the neonatal ICU so that its development is monitored and complications are prevented.
Main causes
Premature birth is more likely to happen in women over 35 or under 16, is pregnant with twins, has had another premature birth or when she loses blood through the vagina in the third trimester of pregnancy. In addition, other situations that can cause premature labor are:
- Premature rupture of the amniotic pouch;
- Weakening of the cervix;
- Bacterial infection Streptococcus agalactiae (group B streptococcus);
- Placental detachment;
- Pre eclampsia;
- Anemia;
- Diseases like tuberculosis, syphilis, kidney infection;
- Twin pregnancy;
- In vitro fertilization;
- Fetal malformation;
- Intense physical effort;
- Use of illicit drugs and alcoholic beverages;
- Presence of fibroids in the uterus.
In addition, women with a history of vaginosis are also at increased risk of premature birth, because some bacteria can release toxins and promote the release of cytokines and prostaglandins that favor labor. Some foods and medicinal plants can also promote uterine contraction and stimulate premature labor and, therefore, are contraindicated during pregnancy. Check out a list of teas that pregnant women should not consume.
Signs and symptoms of premature birth
The woman may suspect that she is going into premature labor when she has some signs and symptoms, such as:
- Uterine contractions;
- Pressure in the bottom of the belly;
- Increased urge to urinate;
- Increased vaginal discharge, which becomes gelatinous and may or may not contain traces of blood;
- Pain in the bottom of the back;
- Diarrhea in some cases;
- Intense colic.
Therefore, if the woman presents these symptoms before 37 weeks of gestation, it is important that she calls her obstetrician and goes to the hospital to be evaluated and the necessary measures can be taken.
To certify that there is a risk of premature birth and decide what to do in this case, the doctor will be able to assess the measurement of the cervix through transvaginal ultrasound and the presence of fetal fibronectin in the vaginal secretion.
A measurement above 30 mm in the cervix indicates a greater risk of delivery within 7 days and women who have this value should be evaluated for fibronectin. If the woman has measurements between 16 and 30 mm but negative fetal fibronectin has a low risk of delivery, however, when fetal fibronectin is positive, there is a risk of delivery within 48 hours.
Possible complications
Complications of premature birth are related to the baby's gestational age at birth, and there may be:
- Premature delivery at 23 to 25 weeks: most cases can develop severe disabilities, such as cerebral palsy, blindness or deafness;
- Premature delivery at 26 and 27 weeks: some cases may develop moderate disabilities, such as visual impairment, lack of motor control, chronic asthma and difficulty in learning;
- Premature birth at 29 to 31 weeks: most babies develop without problems, but some may have mild forms of cerebral palsy and visual problems;
- Premature birth at 34 to 36 weeks: premature babies develop similarly to those born within the expected date, but are more likely to have developmental and learning problems.
Generally, babies born prematurely are placed in an incubator, as they are not able to maintain body temperature. Thus, this device maintains temperature and humidity similar to the uterus, allowing its development.
Babies under 34 weeks of gestation may be connected to a breathing apparatus, as before 34 weeks of gestation they lack surfactant, a substance that facilitates the entry of air into the lungs and therefore signs such as bluish color of the nails and fingertips, lips and nose flap.
In addition, premature babies are at increased risk of retinopathy, which decreases visual ability, so all premature babies need to wear an eye patch while in the neonatal ICU. The baby is only released home when he reaches 2 kg and when his organs are already more developed, so that he can swallow without a tube and breathe without the aid of devices.
How to prevent premature birth
To avoid premature birth, what the pregnant woman can do throughout pregnancy is to avoid excessive physical activity and follow all the obstetrician's guidelines during prenatal consultations.
However, if delivery begins before the expected time, the obstetrician may recommend the use of medications such as corticosteroids or oxytocin antagonists, which can be used between 25 and 37 weeks of gestation. These techniques to prevent premature birth must be done while in hospital and applied according to the benefits for the mother and baby.