Sign and symptom, diagnosis and intervention of preterm delivery

pregnancy: Sign and symptom, diagnosis and intervention of pre-term delivery

Most of the preterm delivery occurs between 34 to 36 weeks when almost the development of the baby is completed. However, in some cases, some special medical care needs after premature delivery, which usually not a very much critical condition. Therefore, parents must not be panic about the threat of premature labor. But in the case of a baby born before 32 weeks, then the risk of complications is higher and need critical medical attention.    

Braxton Hicks uterine contraction is common after 30 weeks of gestational period. Most of the pregnant women can feel this occasional painless contraction. Tiredness and exertion are the usual cause of generating such contraction, which is controlled by taking rest. 

The difference of true premature contractions from Braxton Hicks contractions is it occurs progressively after regular intervals and gradual occurrence becomes frequent and more prominent.        

The signs of premature labor warning

A woman experiences a range of new sensations throughout her pregnancy journey. The following are some common warning signs of premature labor.   

Feeling of belly tightening at regular intervals

At the initial phase, you may feel something going on your belly, which you never experience before. A noticeable painless predictable contraction occurs frequently, which may be occurred within every 10 minutes or more frequently. You need to observe the time when it initiates and ends. You should call your doctor for immediate support.      

Spotting occurs

Vaginal bleeding after the second trimester is uncommon and provides an indication of labor. However, during pregnancy, unexplained vaginal bleeding is a medical concern. A quick consultation with your OB-GYN specialist is of utmost need at this stage.    

Breakage of water

Sudden leakage of fluid is an indication of water breakage and immediate shifting to maternity ward is required to support this condition. 

Pelvis become heavy 

When the baby’s head moves towards the vagina gives a feeling of vaginal fullness, which is also explained as a feeling of the heavy pelvis. This is a symptom of labor. If this situation occurs before the full-term, then it indicates premature delivery. 

Diagnosis for premature delivery

  • Cervical changes along with uterine contraction occur every ten minutes before 37 weeks of the gestational period are considered preterm labor. The cervical changes include softening, dilation, thinning. However, it is difficult for the doctor also to understand that your condition is truly in labor. Therefore, your doctor recommends you to admit in the hospital for close monitoring. 
  • Doctors suggest pregnant women who have a higher risk of premature wear a belt attached with electronic sensors. This belt can detect any early abdominal contractions. Nursing staff also take regular updates about the uterine activity via telephonic discussion for early detection of preterm labor. Early detection is treatable.  
  • Laboratory tests for hormonal measures through saliva and vaginal secretion can also help to diagnose the possibility of preterm delivery. 
  • Fetal fibronectin (fFN) detection by taking a swab from the cervix during pregnancy can also help to indicate the preterm delivery. fFN acts as a biological glue. The finding of fFN during 24-34 weeks indicates premature disintegration of glue, which causes a high-risk pregnancy by increasing the possibility of preterm delivery. 
  • Cervical changes along with dilation of the cervix can be identified through a vaginal ultrasound and may help the doctor to understand the possibility of premature delivery. 
  • The doctor usually tries to halt the premature delivery until some medical conditions like excessive maternal hypertensive condition or severe uterine bleeding occur due to placental abnormality or fetal distress like slow down heart rate due to lack of oxygen supply. 

Intervention for Premature delivery

  • The chances of premature delivery are increased due to dehydration or bladder infection. But early detection and immediate medical intervention can provide more time to your baby to complete a full term. Rest and hydration are primary intervention which helps to resolve this issue. 
  • If you have pre-term contractions, then your doctor suggests you pelvic rest or nothing to put into your vagina – this means no sexual intercourse, no vaginal examinations. The doctor also suggests you temporary bed rest to avoid gravitational pressure on your cervix. Even some time doctors also recommend you to put your head below during rest for stress reduction on the cervix. Bed rest often gives a better outcome by preventing premature delivery. 
  • Stitching of cervix mouth to restrict preterm birth is also an option may your doctor suggests you. 
  • An obstetrician may prescribe medications to postponing child delivery. But it is difficult to estimate the right time to start this treatment. It has observed that doctors usually prescribe this medication when the two to three-centimeter dilation occurs in the cervix. However, the efficacy of this medication not effective for every case to prevent pre-term delivery. While these medications may not be effective to postpone the birth for a long period. These medications delay the delivery dates only for a couple of days. 
  • Corticosteroid medication is one of the first-line drugs to prevent and lessen preterm complications for newborns. This medication helps to accelerate the organ maturation of the fetus and reduce almost 30% incidence of an infant death rate. Corticosteroids also reduce the scope of respiratory distress syndrome and brain hemorrhage in the neonates which are the two most serious complications associated with preterm delivery. Corticosteroid shots are the effective dosage form and this medicine need to push before 24 hours of delivery to get the most effective result. 

You should consult with your doctor if you had previous experience or family history of preterm delivery, as this information helps the doctor to prepare the right treatment strategy to complete the full-term (40 weeks of gestation) safely.   

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