Expert Talk: Gynaecologist Dr Vijayakumar Explains What You Can Expect If You Go Into Preterm Labour

The specific cause of preterm labour is often unclear and at times, pregnant women with no risk factors might also face such a precarious situation. Complications such as infection or cervical incompetence increase the risk of preterm labour in pregnant women. Women with multiple pregnancies also have a higher chance of giving birth prematurely. In 25% of preterm births, the delivery is planned because the mother and/or baby are suffering life-threatening complications such as pre-eclampsia, kidney disease, or even growth restriction.

TC46 speaks to consultant Obstetrician & Gynaecologist Dr Madhushree Vijayakumar of Motherhood Hospitals, who explains some of the signs and symptoms of preterm labour and how to deal with them effectively.

1. What exactly is preterm labour and how can it affect the baby?

Preterm Labour is a condition in which regular contractions of the uterus results in the opening of your cervix after Week 20 and before Week 37 of pregnancy. This condition lets the baby enter the birth canal. Preterm labour can result in premature birth and associates baby with greater health risk. Premature babies need special care in the neonatal intensive care unit and can also have long-term mental and physical disabilities.

2. Can you tell us the signs and symptoms one must look out for to identify preterm labour?

Signs and symptoms of preterm labour include:

• Regular or frequent sensations of contractions in the uterus
• Constant low and dull backache
• A change in the type of vaginal discharge like, watery, mucus-like or bloody
• Light bleeding or vaginal spotting
• Changes in hormones
• Mild abdominal cramps
• Infections 

3. Can preterm labour stop on its own?

The labour stops on its own in about 30% of preterm labour cases. The treatment depends on circumstances and on doctor’s recommendation for whether to try medication and delay delivery or speed the development of the baby, whichever situation is suitable.

4. What are some of the factors that result in preterm labour?

There are many risk factors that are associated with the results of preterm labour. Some of these are:

• Smoking and use of illegal drugs
• Problems with the placenta or uterus
• Pregnancy with twins, or other multiples
• Previous preterm labour, particularly in the most recent pregnancy or in more than one previous pregnancy
• Age of the mother is under 20 years or over 35 years old
• Shortened cervix
• Foetal birth defect in past
• Stressful life events
• Some chronic conditions such as depression, diabetes, autoimmune disease and high blood pressure
• Premature rupture of membranes

5. What are the risk factors associated with preterm labour and preterm birth?

Preterm labour and preterm birth lead to the premature birth of the babies which leads to various health risk factors. Premature babies are kept in a neonatal intensive care unit because they are born early from the time period. Many premature babies have long-term mental and physical disabilities. It also affects the reproductive health of a woman as she might face the same circumstances in her next pregnancy.

6. Are there any lifestyle changes one must make to avoid preterm labour?

Other than age and ethnicity, there are a few changes in lifestyle can prevent you from preterm labour such as:

• Avoid recreational drugs, alcohol and smoke: It is important to avoid these things during pregnancy, especially during the first three months. This can harm the development of the baby and can impose a higher risk of having your baby prematurely and they may have problems with growth and brain development.
• Eat a healthy diet: A healthy diet is the key to every problem and is often associated with a healthy pregnancy. Some research suggests that a diet high in polyunsaturated fatty acids (PUFAs) is associated with a lower risk of premature birth.
• Weight: There is a higher risk of preterm birth if the mother is underweight particularly if your BMI is below 19.8. Obese or overweight also increases the chance of miscarriage along with other problems.
• Consider pregnancy spacing: Research suggests a link between pregnancies spaced less than six months apart, or more than 59 months apart and an increased risk of premature birth. 

7. Are there any treatments available to stop or slow down preterm labour?

There are a few treatment options that can stop or slow down preterm labour but the effectiveness of these treatments are subjective and vary from case to case:

• Bed rest in hospital or home
• Tocolytic medicines help to slow or stop contractions
• Corticosteroids help the lungs of your baby grow and mature. Preterm babies’ lungs may not be able to work on their own
• The procedure of cervical cerclage is used to stitch the cervix closed. It may be done when the cervix is weak and not able to stay closed.
• Antibiotics to treat the infection

8. What is pregnancy spacing and how does it affect preterm birth?

Pregnancy spacing is the term used for giving space and time between two pregnancies. According to some research, there is a link between pregnancies spaced less than six months apart, or more than 59 months apart and an increased risk of premature birth. It is advisable to consult your doctors for planning your pregnancy and space needed.

9. What are some foods one must include in their diet to have a healthy and full-term pregnancy?

A healthy diet is an important part of a healthy lifestyle at any time, but especially vital if you’re pregnant.  A healthy diet gives your baby the essential nutrients they need in the womb. There should be an aim for a balanced healthy diet with a blend of these five food groups: vegetables and legumes, bread and cereals, milk, yoghurt and cheese, meat, poultry, fish and alternatives, fruit. Foods containing protein like meat, fish, chicken, eggs, milk, cheeses, nuts, beans and legumes help a baby grow.

10. Can you tell us 5 things expectant mothers should know about preterm labour management?

5 things that an expectant mother should know about preterm labour management are:

• Seek regular prenatal care to monitor your health and the baby’s too. Mention any symptoms of preterm labour if it concerns you. Visit your doctor regularly if you had or have any preterm labour or delivery.
• Consume a healthy and balanced diet
• Manage chronic conditions such as diabetes, high blood pressure and obesity, because it increases the risk of preterm labour.
• Avoid consumption of harmful substances such as smoking, drinking, etc.
• Take all the medications and treatment sincerely recommended by a doctor.

Disclaimer: This is for the general information of the readers. Please consult a doctor for specific health-related problems.