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Consequences of premature birth for the child. What can cause preterm labor? Causes of premature birth. The main thing - do not overwork

Premature birth, that is, the birth of a child before the onset, has become a very common phenomenon in modern life. Why do women give birth prematurely? What determines how long a baby spends in the mother's womb? How to know that preterm labor has begun? We will try to answer in this article the questions that concern many women.

Premature birth: causes

In a perfectly healthy woman, the risk of having a baby earlier than expected is minimal. In order to prevent late delivery, you should take your health responsibly even before conception. First of all, it is necessary to undergo a gynecological examination for the presence of genital infections. Often, mycoplasmas, Trichomonas, chlamydia, and the herpes virus can provoke early childbirth. If there are these diseases, it is necessary to be treated before the planned conception of a child.

Abortions or miscarriages can also predict. The reasons may be as follows:

  • Congenital malformations of the fetus or uterus of the mother;
  • Detachment of the placenta;
  • Multiple pregnancy;
  • Insufficiency of the cervix;
  • Increased levels of male hormones;
  • Hormonal disorders;
  • polyhydramnios;
  • Intrauterine device;
  • Rupture of the membranes.
  • Infectious diseases. Influenza, pyelonephritis, tonsillitis and other diseases accompanied by high fever can cause premature birth.

The reasons may also be psychological. Constant stress, depression can affect premature delivery.

Physical activity, harmful work, drinking alcohol and smoking can also cause the child to be born earlier than the due date. The risk group includes young women under 17 years of age and women over 35 years of age. during the period of bearing a child is also capable of provoking premature birth. The reasons, as we see, can be different, so you need to be very careful about your health.

Symptoms

Symptoms of early childbirth are nagging pain in the lower abdomen of a cramping nature and pain in the lumbar region. The pain may be accompanied by nausea and diarrhea. At this time, the fetus may decrease or increase. The gynecologist will be able to determine the presence of uterine tone by palpation or with the help of ultrasound, therefore, if there are such symptoms, you should immediately consult a doctor. separation of the mucous plug is also a symptom of an impending birth. Childbirth can occur without preliminary contractions, if the uterus is not able to hold the fetus. If you turn to a medical institution for help in time, you can extend the term of childbirth in a hospital stay.

The life and health of the child largely depend on the week in which the premature birth occurred. 30 weeks is the time when the baby reaches a weight of 1200-1800 grams and at this time most newborns are able to survive under the supervision of doctors. Until 30 weeks, the child is not yet fully mature, but, nevertheless, children born before this period also survive, but much less often. At 36 weeks, the baby is quite viable, his organs are mature, able to provide the body with oxygen. A premature birth at 36 weeks is more likely to be successful, but the baby will have to spend some time under the supervision of doctors.

In order to be prepared for such a situation, it is necessary to undergo a thorough examination before conceiving a child and lead a correct lifestyle throughout the entire period of pregnancy.

Premature births are those that occur between 22 and 37 weeks of gestation, inclusive, with a fetal weight of 500 to 2500 grams. Preterm births account for 5-10% of all births.

Classification of preterm birth

By deadline all preterm births are divided into:

Very early (term 22-27 weeks of pregnancy inclusive with a fetal weight of 500 to 1000 gr.);

Early (for a period of 28-33 weeks with a fetal weight from 1000 to 2000 gr.);

Premature birth (in the period of 34-37 weeks with a fetal weight of 2000 to 2500 gr.).

Most often, preterm births (more than 50% of all cases) occur at 34-37 weeks of gestation with the most favorable outcome and a high percentage of fetal survival.

Childbirth at a period of 22-27 weeks with the viability of the child for 7 days is considered premature, otherwise it is considered a late miscarriage.

With the flow distinguish:

Spontaneous preterm birth (make up about 80% of all preterm births);

Artificially induced (indications - severe diseases and conditions that threaten the life of a woman, intrauterine fetal death, fetal malformations incompatible with life).

By stages of development distinguish between premature births:

Threatening (accompanied by pulling pains in the lower back and lower abdomen, tone or contractions of the uterus, the cervix is ​​​​closed);

Beginning (characterized by clearly expressed cramping pains, sanious discharge, discharge of the mucous plug, cervical dilatation 1-2 cm, possible outflow of water);

Started (with the presence of regular contractions with intervals between them less than 10 minutes, rupture of the membranes, discharge of amniotic fluid, dilatation of the cervix more than 2 cm, bloody discharge from the genital tract, the presenting part of the fetus is located at the entrance to the small pelvis).

Causes of preterm birth

1.Related to women's health problems

Gynecological (malformations of the uterus, the consequences of abortion - scars and adhesions, isthmic-cervical insufficiency - weakness of the muscles of the cervix, which cannot withstand the growing pressure from the fetus);

Infectious (acute and chronic diseases of the genital and other organs of an infectious nature);

Endocrine (diseases of the endocrine glands, accompanied by a violation of their function).

2. Associated with fetal health problems (various deviations from the norm and malformations of the fetus, hereditary diseases).

3. Complications of the current pregnancy (severe forms of preeclampsia, Rhesus conflict, incorrect position of the fetus, polyhydramnios and multiple pregnancies, placenta previa or abruption, outflow of water).

4. Socio-economic factors (physical labor, unfavorable living conditions, bad habits, poor nutrition, stress, a woman's age is less than 18 and more than 35 years).

Management of preterm birth

If there is a threat of premature birth, it is urgent to call an ambulance, lie down, take a sedative and 2-4 no-shpa tablets. The sooner you seek help, the more likely you are to maintain your pregnancy and prevent unwanted preterm labor. Remember that every week spent in the mother's belly significantly increases the chances of your child to survive and have a successful pregnancy!

In the hospital, the cause of premature birth is clarified, the condition of the woman, the baby and the fetal bladder is assessed, the gestational age and the estimated weight of the fetus, as well as the stage of development of premature birth, are determined.

Complete physical rest and bed rest are prescribed. Measures are being taken to eliminate the causes of premature birth and pregnancy-preserving therapy (drugs are introduced that suppress uterine contractions and reduce its excitability). In parallel with this, therapy is prescribed to increase the viability and maturation of the fetus. Prevention of the so-called distress syndrome of the newborn (a number of respiratory dysfunctions due to lung immaturity) is being carried out. The condition of the woman and the child is constantly monitored.

If it is impossible to save the pregnancy (the stage of the onset of preterm labor, discharge of water, etc.), the question of the method of delivery is considered. Premature births are necessarily anesthetized.

A caesarean section is performed if the estimated fetal weight is less than 2000 grams, and the gestational age is less than 34 weeks, with breech presentation of the fetus, the presence of diseases of the cardiovascular system in the mother, and uterine bleeding.

Complications of preterm birth

Premature births are more traumatic for the mother and baby than full-term births, and complications after them occur much more often.

Preterm labor in most cases is rapid, since the birth of a premature baby does not require full disclosure of the cervix. Due to the rapid passage through the birth canal, birth injuries in the fetus and soft tissue ruptures in the mother are possible.

Less common is weak labor activity, in which the duration of labor increases and fetal hypoxia develops.

Even less often, discoordinated labor activity is observed, in which the order of contractions is disturbed, the contractions are more painful, and in the intervals between them there is no complete relaxation of the muscles of the uterus.

The percentage of infectious complications after preterm birth, such as endometritis (inflammation of the uterus) and suppuration of the sutures, is much higher than after delivery at term. Very rarely, sepsis (generalized infection) and peritonitis (inflammation of the peritoneum) can occur.

Prevention of preterm birth

First of all, the prevention of preterm birth includes the elimination of possible causes (most often infections) even at the stage of pregnancy planning;

Early registration in the antenatal clinic, regular monitoring of pregnancy, especially if there is a history of premature birth, abortion or spontaneous miscarriage;

Timely delivery of tests, detection and treatment of infections during pregnancy;

Prevention, detection and treatment of complications arising during pregnancy;

Regular ultrasound monitoring of fetal development;

Mandatory hospitalization and treatment in the event of threatening preterm birth.

Pregnancy is a wonderful period that ends with childbirth. But in some cases, for various reasons, labor may occur earlier, for example, at 30 weeks. Expectant mothers are very afraid of such a phenomenon and are trying in every possible way to protect themselves from factors that could provoke the untimely birth of a baby, but there are those who do not know about them. Why is premature birth so dangerous, and what causes it?

Causes

At 35-37 weeks of pregnancy, the body of a woman and a child are already ready for childbirth. If the birth of the baby comes before the set time, the birth is called premature.

The reasons for this phenomenon can be different, the most common include:

  1. Infectious diseases and various types of inflammation. Each inflammatory process that is localized in the uterine cavity leads to damage to the muscle tissue and prevents it from stretching. This is unacceptable, as the baby is growing and he needs enough space. If the uterus cannot stretch, it tries to get rid of the fetus, which leads to premature birth.
  2. Pathology of the cervix. The threat of premature birth for the above reason most often occurs at 27-29 weeks and subsequent. Pathology is represented by isthmic-cervical insufficiency, which is expressed in the weakness of the uterus and its inability to hold the fetus. As a result of pressure, the uterus opens, which leads to untimely delivery. Most often, the cause of such a pathology is the presence of abortions or miscarriages in a woman, in which the scraping method was used.
  3. Multiple pregnancy. When carrying more than one baby, the uterus is strenuously stretched, which leads to the premature birth of children.
  4. Various types of disorders and diseases. The cause of untimely birth can also be illnesses in the expectant mother, for example, diabetes, problems with the thyroid gland and the endocrine system.
  5. External factors. The threat of premature birth may be in women who are subject to hard physical labor, stress, and take drugs, alcohol and smoke.

The presented factors are far from the only ones that can provoke a premature birth of a child. There are many more reasons and very often, they depend on the individual characteristics of the woman and her lifestyle.

It is very important to visit a specialist regularly so that the pregnancy passes without any failures and threats. It is recommended to take tests that will help identify the presence of infections before pregnancy.

Symptoms

If you give birth at 22-28 weeks of pregnancy, the weight of the baby will be from 500 to 1000 grams. If the child survives within a week, his birth is called premature birth, if not, late miscarriage. Babies who are born at 29-37 weeks most often weigh from 1000 to 2500 grams, this body weight is considered sufficient for normal life.

The body of a premature baby cannot independently control all important processes. It is too vulnerable, as there is an immaturity of the nervous and endocrine systems, and some reflexes are also absent. A child born prematurely requires special care and control by doctors.

Childbirth at 30 weeks of gestation can occur with the following symptoms:

  • Minor pains and contractions appear in the lumbar region and lower abdomen.
  • There is a tension of the uterus, the stomach becomes hard.
  • The woman begins to feel the frequent and restless stirring of the baby.
  • Abundant discharge with an admixture of blood or bloody mucus appears.
  • Minor and short contractions begin.
  • The mucous plug comes off or water leaks.
  • On examination, the uterus is soft and slightly open.

With such symptoms, you should immediately visit a gynecologist. If appropriate treatment is provided in time, childbirth will not begin at 30. If you ignore the changes, the process of premature labor can no longer be stopped.

Consequences of premature birth

For those who gave birth prematurely, the consequences were fraught, especially on the part of the psyche. Expectant mothers are very worried about the threat of miscarriage, so premature birth is a big psychological trauma for them. Often, such women suffer from postpartum depression.

The most difficult consequences of early childbirth endure the baby. Since his body is not fully formed and not all systems function correctly, it requires connection to a special chamber that ensures proper breathing.

Babies born before 35–37 weeks cannot breathe normally. They have poorly developed lungs and practically no surfactants. To eliminate problems, specialists use special drug therapy. It is very important that the child stays in the chamber until the functioning of the respiratory organs is fully normalized.

Some babies have immaturity of the lung tissue, which in the future leads to the development of diseases of the respiratory system. To avoid this, drugs are prescribed, the action of which is aimed at tissue growth. The child is constantly under the control of devices that reflect the functioning of his organs, in particular, the heart. As part of the therapy, an artificial nutrition apparatus is used so that the baby receives all the necessary fats, proteins, carbohydrates, as well as other useful substances.

With proper rehabilitation, premature babies will grow up healthy and active.

How to avoid preterm birth?

If there is reason that labor will begin at the 30th week of pregnancy, a number of measures must be taken to prevent this process. First you need to immediately visit a specialist and get advice.

  1. Pay special attention to the appearance of painful sensations that resemble menstruation, unusual discharge, increased mobility of the child.
  2. Pass the necessary tests, undergo an ultrasound procedure, hCG, and also follow all the additional recommendations and appointments of a gynecologist.
  3. If the examination showed the presence of anemia, thrush or other disease, undergo appropriate treatment, but only under the supervision of a doctor.
  4. If necessary and the conclusions of a specialist, stay in the inpatient department.

Treatment of preterm birth at thirty weeks is aimed at stopping them and threading the gestational age to the standard.

Methods of treatment

During the period of therapy, medications and non-drug methods of treatment can be used. The latter include:

  • Ensuring sexual, emotional and physical peace.
  • Bed rest with legs elevated.
  • Physiotherapy procedures.

Of the medicines, drugs are prescribed that provide a stop in labor and relaxation of the uterus. Sedatives are also used and those that are aimed at eliminating the symptoms of premature birth.

Andrenomimetics are often used in combination with calcium channel blockers. It can be Ginipral, Nifedipine, Verapamil and other drugs. Initially, such funds are administered intravenously, then tablet forms can be used.

In order for the treatment to be effective, it must be carried out in a hospital, under the supervision of doctors.

To avoid the phenomenon of the early appearance of the baby at any week of pregnancy, it is necessary to carry out appropriate prevention. It includes the delivery of all necessary tests for infectious diseases and the control of chronic pathologies.

Nowadays, preterm births have become quite common. Despite modern medical equipment that allows us to nurse premature babies even in very severe cases, we all understand that it is better if the growth and development of the child to the physiological norm occurs in the mother's womb, and not in an incubator, albeit an ultramodern one. That is why the threat of preterm birth is the number one fear among the "pregnant audience".

The problem of premature birth is quite serious, of course, that talking about this will not raise the mood of the expectant mother! But you should not worry and be afraid ahead of time either, because the probability of a successful delivery is much higher than the birth of a baby prematurely. In addition, if you know the signs of the onset of preterm labor and take the necessary measures in time, then the baby can be prevented from being born ahead of schedule. We'll talk about this a little lower.

What is preterm birth?
Premature birth is always associated with the struggle for survival, with a long, difficult and expensive treatment aimed at the recovery of the baby. I note that such cases do not always have a happy ending. The earlier the period at which the pregnancy was interrupted, the more often babies have vision problems, severe neurological disorders, etc. It is difficult to overestimate the risk of an early birth for a baby, because his body is simply not ready for independent functioning: the lungs, the gastrointestinal tract are not ready, his body cannot maintain body temperature, etc.

There are cases when induction of premature birth is simply necessary (for medical reasons or at the request of the pregnant woman). According to Russian legislation in our country, abortion can be carried out up to 22 weeks, this is no longer considered an abortion, but premature birth, despite the fact that they are classified as a late miscarriage. If a week after such an interruption of pregnancy, the child remains alive, then such births are classified as early premature, and the surviving fetus is considered a child.

The method of carrying out premature birth is determined by an obstetrician-gynecologist, taking into account the reasons that caused them. If the birth canal is not ready, and if the causes are late toxicosis, which is a threat to the life of the mother, eclampsia or convulsions, a caesarean section is performed, despite the almost complete absence of a chance that the child will survive.

If time does not play a role or abortion is carried out for social reasons, doctors perform the usual preparation of the birth canal using drugs that cause premature birth.

What kind of birth is considered premature?
Premature births are considered to occur before 37 weeks of gestation. In obstetric practice, there are intervals in which preterm birth can occur:

  • for a period of 22 weeks;
  • for a period of 22-27 weeks;
  • for a period of 28-33 weeks;
  • for a period of 34-37 weeks.
Since January 1, 1993, in our country, according to the new live birth criteria recommended by the World Health Organization, intensive and resuscitation care is provided to newborns weighing 500 g or more, born from the 22nd week of pregnancy. Until 1993, preterm births were considered those that occurred after the 28th week of pregnancy, and resuscitation was only for newborns weighing over 1000 g.

Babies born at 29, 30, 31 weeks of pregnancy almost always weigh more than a kilogram, their lungs are relatively well prepared for breathing, so they initially have a good chance of survival. But prematurity is not the only problem, often it is associated with hypoxia in labor and before childbirth, natal (birth) trauma (which often leads to the death of babies) and other diseases that caused preterm birth.

Causes and symptoms of preterm labor.

  • Endocrine diseases in a pregnant woman increase the risk of preterm birth and problems during pregnancy. These include hormonal imbalance in the genital area, thyroid disease, diabetes mellitus.
  • Sexual infections (chlamydia, ureaplasmosis, etc.) that a woman has during the period of bearing a child double the risk of preterm birth. In addition, they can cause disease and malformations in a child. Cervical erosion, chronic salpingitis, endometritis, bacterial vaginosis also pose a threat.
  • Somatic infections (SARS, tonsillitis, viral hepatitis, untreated teeth) are a source of infection for the fetus and can provoke premature birth.
  • The presence of malformations, anomalies and tumors of the uterus, changes in the cervix and adhesions due to childbirth and abortion in most cases are the factor that provokes the onset of premature birth. Damage to the circular muscles of the isthmus of the uterus (usually during childbirth or during abortion), which prevent its disclosure during the bearing of the baby, leads to the occurrence of isthmic-cervical insufficiency (ICI). With this phenomenon, the cervix, under the weight and pressure of the fetus, begins to open slightly from 16-17 weeks of pregnancy, the fetal bladder “bulges” into it, which becomes infected, as a result, breaks, provoking premature birth.
  • Somatic diseases of a non-infectious nature in a pregnant woman (diseases of the kidneys, heart and liver, exhaustion, malnutrition) contribute to the weakening of the body and complicate the course of pregnancy. In this situation, preterm birth occurs very often.
  • Malformations of the fetus and the presence of genetic diseases provoke premature birth. Usually the threat occurs already at 32 weeks of gestation.
  • Various complications and features of pregnancy are also a risk factor. This includes the expectation of twins (premature births occur against the background of uterine hyperextension), polyhydramnios, complications in the form of preeclampsia in the later stages, feto-placental insufficiency, placenta previa and abruption. All this can also cause premature birth.
  • genetic features.
  • Abdominal injury.
  • The presence of bad habits in the mother.
  • Female age under 18 and age over 30 are risk factors.
  • Heavy physical labor, lack of sleep, chronic stress, mental strain.
  • Poor nutrition and living conditions.
  • Incomplete family, unwanted pregnancy.

Premature birth and gestational age.

Premature birth at 22-27 weeks.
Children born at this stage of pregnancy have the lowest survival rate, since their lungs are not yet mature, and their weight is in the range of 500-1000 g. The main factors that provoked premature birth at this stage of pregnancy are isthmic-cervical insufficiency, infection of the fetal bladder and his break. A child born at 22-23 weeks has practically no chance of survival, and those few who could survive (and there have been such cases in obstetric practice) become disabled in the future. Those born between 24 and 26 weeks are more likely to survive, and the prognosis for their health is much better. Premature births between 22 and 27 weeks of gestation occur in only five percent of cases.

Premature birth at 28-33 weeks.
Most children born at this term survive safely, which is largely due to the high level of development of neonatological care, however, it is worth noting that not all children have the fact of prematurity without consequences. Typically, children in this group weigh from 1000 to 1800 grams, their lungs are practically prepared for breathing. At this time, premature birth can occur for a variety of reasons, ranging from pregnancy complications to Rhesus conflict.

Premature birth at 34-36 weeks.
To be born at this stage of pregnancy for the child is not dangerous. A healthy, but premature baby born in a maternity hospital has every chance of quick adaptation and excellent health in the future. The weight of babies born at this time is usually more than two kilograms, the lungs are ready for independent work, a little support with medicines is required to accelerate their maturation. The main culprits of premature birth at this time are somatic diseases of the expectant mother, various complications of the course of pregnancy and intrauterine hypoxia against the background of feto-placental insufficiency.

Symptoms and signs of preterm labor.
Signs of preterm labor can be compared with the threat of termination of pregnancy in the early stages. Most often, their onset is indicated by the outflow of amniotic fluid, but a few days before this, a woman usually has symptoms-harbingers, to which she usually does not pay attention.

In obstetric practice, there are several stages of preterm birth:

  • Threatening premature birth. During this period, the symptoms of premature birth may not even be noticed. These include nagging pains in the lower back and lower abdomen of a weak nature, tension or contraction of the uterus, which can be seen by placing a hand on the stomach (usually it tenses up), restless behavior of the baby (kicks more often), the appearance of mucous secretions from the genital tract, sometimes with an admixture of blood (on examination, the uterus is dense and closed). Contacting a doctor at this stage will help to avoid premature birth, usually minimal medication is prescribed and absolute rest is recommended for the pregnant woman.
  • Beginning premature birth. Symptoms are more pronounced, in particular, pain in the lower back and lower abdomen become more intense, cramp-like. At this time, the mucous plug often leaves, discharges from the genital tract of a bloody nature are observed, and water is often poured out. During the examination, the specialist reveals the shortening and softening of the cervix, its opening by 1-2 fingers.
  • Started premature birth. Usually, if the process of childbirth has begun, it can no longer be slowed down. Often, preterm births have a rapid course, for example, in primiparas they pass in 6 hours, with repeated births this time can be halved. The pains become very intense, acquiring a cramping character, and the contractions become regular (every ten minutes or less), the cervix quickly opens, the water leaves, the fetus pushes through to the entrance to the small pelvis.
So, if there are pains resembling pain during menstruation, a feeling of heaviness in the lower abdomen and pressure on the bottom, the activity of the fetus has increased significantly or, on the contrary, weakened, unusual discharge from the genital tract has appeared, you should know that these are the first signs of premature birth. In this situation, in order to “calm down” your “hurry”, you need to seek medical help immediately. Any delay can cost you dearly. In any case, it is better to play it safe in advance than to regret your short-sightedness and carelessness later.

Treatment of threatened preterm birth.
Usually, if a pregnant woman sees a doctor at the stage of threatening preterm labor, she is recommended to be hospitalized in a maternity hospital, but this is not so necessary in all cases. Of course, first a gynecological examination is performed, tests are taken, the condition of the cervix, the child is assessed, the presence or absence of an infection in a woman is revealed.

It is worthwhile to dwell on the leakage of amniotic fluid in more detail. Very often, because of fear, women do not go to the doctor if the water has broken, and the contractions have not yet begun, but in vain. In this case, no one will immediately terminate the pregnancy (there is nothing to be afraid of), especially if its terms have not reached 34 weeks. If there are no signs of infection, the pregnant woman is simply placed in the maternity hospital, where for several days (five to seven or more) specialists will prepare the lungs of the fetus for independent work (glucocorticoids are usually prescribed), while the pregnant woman herself will be protected from infection by antibiotic therapy and the creation of sterile conditions . Delivery will occur only after the lungs of the fetus are ready so that the baby can breathe on its own. Prolongation of pregnancy in case of premature rupture of the membranes is carried out based on the timeliness of treatment and the condition of the pregnant woman at the time of treatment.

With the threat of premature birth for a period of 35 weeks or more with the outflow of amniotic fluid, the pregnant woman is delivered, because the adaptation of such children to extrauterine life is, as a rule, successful. If the amniotic sac is preserved, treatment is aimed at stopping the onset of labor and eliminating the cause that caused it. If there is only a threat of preterm birth, outpatient treatment is sometimes possible, but hospitalization is recommended in most cases. Often, creating a calm environment for a pregnant woman is enough to stop labor activity and continue the pregnancy.

Once the birth process has begun, it cannot be stopped. If the fetal bladder is intact, then drugs are used as therapy, the action of which is aimed at relaxing the uterus, as well as sedative therapy, physiotherapy and bed rest.

If the treatment was unsuccessful, the contractions did not stop, but increase each time, the question of delivery arises.

Danger of rapid premature birth.
As a rule, premature labor, which is of a rapid nature, is always associated with hypoxia, which is due to frequent uterine contractions and too rapid progress of the fetus through the birth canal. Soft bones and small sizes of the fetal head, as well as weak vessels in combination with the above, can provoke severe birth injuries of the fetus, intracranial hemorrhages and trauma to the cervical spine. By the way, it is precisely because of the way the birth process proceeded, in the case of premature birth, that a premature baby may suffer, and not because of the fact of prematurity.

If the specialists could not stop the premature birth, then they do everything to ensure that the birth takes place as carefully as possible. No methods are used to protect the perineum from ruptures, as this can cause injury to the fetus. Even in the case of breech presentation of the fetus, childbirth is carried out naturally (in the absence of contraindications), and in hospitals all conditions have been created for nursing newborns. In the case of deep prematurity, a caesarean section is performed.

In the case of discoordinated labor activity or its weakness, gentle labor is performed with thorough anesthesia, careful stimulation with simultaneous monitoring of the fetal condition.

If the pregnancy was prolonged after the outflow of amniotic fluid, there is a high probability of developing endometritis and postpartum hemorrhage. Preterm birth at 35 weeks has virtually no complications.

Caesarean section for preterm birth is not used if the fetus is not deeply full-term, and there are clear signs of chorioamnionitis and intrauterine infection, as well as in the case of intrauterine death of the fetus.

In these situations, natural childbirth is necessary, a caesarean section poses a threat to the life and health of a woman.

Prevention of preterm birth is to eliminate the factors that cause them even at the stage of pregnancy planning. Therefore, it is very important to be healthy at the time of pregnancy, or if it happened by chance, it is necessary to register and undergo an examination as soon as possible.

Preterm birth in Russia occurs in 7% of all cases - in the vast majority of women give birth on time. However, for the pregnant woman herself and her unborn baby, it is of fundamental importance whether she falls into this category or not. Often, premature birth of a child can be avoided if you correctly behave at a moment threatening pregnancy.

premature babies

Fully mature pregnancy is considered from 37 weeks. The onset of childbirth before this period is called premature. But there is one very important clarification: childbirth (and not miscarriage) is supposed to be called the birth of a child in the period from. Moreover, if the weight of the fetus at the same time reaches at least 500 g, doctors are forced to desperately fight for his life. This is prescribed by law. But in practice, unfortunately, often things do not look quite right. Saving and supporting such a crumb is a very expensive, responsible process that requires highly qualified medical staff. The organs and systems of such a tiny child have not yet been formed and developed properly, he cannot even breathe on his own. That is why, with the existing threat of preterm birth, literally every day matters, which will help the baby at least a little, but still grow up and get stronger in the mother's tummy: this, of course, increases the chances of survival in the event of childbirth. Therefore, be responsible if your doctor tells you about the need for inpatient care due to the high risk of preterm birth.

Causes of preterm birth

Mothers who are at risk for premature delivery need to be especially vigilant. And there can be many reasons for the premature birth of a baby.

First of all, these are genital infections. An infected uterus is unable to complete the task. She stretches as long as she can, after which she simply rejects the fetus.

Before the due date, childbirth also occurs with isthmic-cervical insufficiency (ICN), when the cervical canal of the uterus cannot hold the fetus in the womb due to its muscular failure.

Other obstetric and gynecological causes of preterm birth include placental abruption or placenta previa, premature rupture of the membranes, congenital malformations of the uterus, as well as too much stress on it during the gestation period: multiple pregnancy, carrying a very large fetus. An intrauterine device not removed in time, or its intrauterine death also ends in premature birth. If you have had abortions in the past or the previous pregnancy was at risk of premature birth or there were ruptures of the cervix, then the risks increase markedly.

Doctors may decide to induce premature birth in severe cases, when a real threat looms over the life of a woman and the fetus.

In addition, there are many other factors that can provoke an early onset of childbirth: heavy physical labor of a pregnant woman, poor nutrition, unfavorable psycho-emotional conditions in the family or transferred, endocrinopathies, disorders of the heart or kidneys,. Pregnancy at a very young or mature age also poses a certain risk.

It is impossible not to say that often births that are perceived as premature actually occur on time, a mistake was simply made in determining the expected date of birth. Therefore, it is important to determine the date of conception as accurately as possible and calculate your gestational age.

Of great importance is how a woman reacts to the diagnosis of threatened preterm birth. Because anxiety and anxiety only exacerbate the situation. Therefore, you need to learn how to relax and set yourself up in a positive way. But still, do not lose vigilance and, if necessary, act accordingly.

Guide to action

Harbingers of preterm labor are no different from the onset of labor on time with only one difference - they appear much earlier than expected. At first, a woman feels pulling pains in the lower abdomen, radiating to the lower back, which indicates an increased activity of the uterus, that is, it contracts inappropriately. The motor activity of the child will change: he either freezes, or makes itself felt very strongly. At the next stage, the mucous plug and even amniotic fluid may come off - there is nothing to think about here, hospitalization is necessary as soon as possible. This indicates that the uterus begins to open, while cramping pains become more frequent and intensify.

If the cause of premature birth is cervical weakness, then the whole process can be almost asymptomatic. The only thing a woman feels heaviness in the vagina is the fetal bladder descends.

In general, preterm labor is faster and easier because the baby is still very small. Therefore, you need to act quickly.

If you have been diagnosed with threatened preterm labor, but you have stayed at home, you should be extremely careful and attentive. Any physical activity must be excluded, including walking and. Do not lift anything heavy, do not make sudden movements, and go on a diet that excludes heavy and provoking food.

As soon as you feel the first signs of childbirth, take a sedative (motherwort or valerian), 2-3 tablets of No-shpa, call an ambulance and lie down comfortably, preferably on your side.

What awaits the woman in the hospital?

Further events can develop in several variations. If the woman's condition is critical, then doctors will have to take delivery. They do not attempt to prolong the pregnancy even in the case when the amniotic fluid leaves after the period. At the same time, during the adoption of premature birth, the doctor constantly monitors the fetus with the help of a heart monitor. If the baby's vital signs are unsatisfactory, a caesarean section will be performed.

In all other situations (when giving birth is still early and inappropriate), doctors should make every effort to maintain the pregnancy and delay the date of premature birth. If possible, then up to 37 weeks.

First of all, doctors will calm the uterus and normalize blood circulation in the placenta by introducing medicinal solutions by setting, and later they will switch to tablets.

At the same time, the doctor must find out the reason why the birth began ahead of schedule in order to eliminate it if possible. If a woman's water has broken, antibiotic therapy will be started, since the path for infections to the fetus is now open. The same should be done if the cause of the onset of premature birth was an infection.

The woman will certainly begin to be given Dexamethasone, which accelerates the development of the baby's pulmonary system in case the birth does begin earlier. As a rule, it also cannot do without sedative drugs: firstly, it could provoke the onset of childbirth, and secondly, a woman’s fear of losing a child involuntarily leads the uterus into. Mostly homeopathic medicines are prescribed.

If the cause of the threat or the onset of preterm labor is the development of ICI, then the cervix must be stitched (which is done under internal anesthesia). And if the situation arose after the 28th week of pregnancy, a special supporting Golgi ring is inserted into the vagina.

After childbirth

A prematurely born child, as we have already said, requires increased attention, help and special self-care. His mother will probably be detained in the maternity hospital longer than usual, and even after discharge, it will be necessary to follow the recommendations of doctors for caring for the baby. The very same puerperal will have to undergo a series of studies to prevent the development of postpartum complications. And in the future, if there are others after this pregnancy, they will be under the close supervision of doctors, especially during critical periods during gestation.

But it will be later. And now mom will enjoy the happiness of motherhood.

Especially for- Elena Kichak