Treatment of preterm labour

It is difficult to prevent preterm labour for there are times when it is unavoidable and indeed necessary to deliver a baby.

There are ways to promote an optimal pregnancy and these efforts should be foremost in antenatal care:

  1. Seek appropriate antenatal care
  2. Gain weight carefully: weight gain of 11-16kgs is recommended. If you are overweight at the beginning of your pregnancy then less may be advisable.
  3. Eat a healthy diet: this ensures the baby is receiving the right nutrients. A supplement of folic acid or prenatal vitamin can ensure any deficits in your diet.
  4. Avoid harmful substances: Smoking not only risks the delivery of babies that are small for gestational age but can trigger preterm birth. Alcohol, illicit drugs and even some prescription medications require caution in relation to triggering a premature birth. Discussing these with your doctor regarding caution is the best way of avoiding an early birth.
  5. Assisted reproductive technology: it is common for multiple embryos to be implanted and counselling should be considered regarding this and the increased risk of preterm birth connected with a pregnancy of multiple babies.
  6. Pregnancy spacing: it has been suggested that pregnancies spaced less than 6 months apart can increase the risk of preterm birth. Discussing this with your doctor is advised.

If there is a notable risk of preterm labour, the amniotic sac has torn before 37 weeks or preterm contractions have commenced, there are some medical treatments available that may be able to delay birth.

Medical intervention:

  1. Cervical cerclage: this is a suture or stitch to the cervix that decreases the risk of preterm delivery in women with incompetent cervix.
  2. Progesterone: the use of progesterone gel or injections when there is the presence of a shortened cervix can stop contractions and thus a preterm birth.
  3. Antibiotics:  treatment of urinary or vaginal infections with antibiotics can reduce the chance of preterm birth. Antibiotics are also given if the amniotic sac has broken and fluid is leaking which can be a conduit for infection to enter the uterus.
  4. Tocolytic medications: a medication called a tocolytic may be given to stop contractions if they have started. They are unlikely to prevent labour for very long but in very preterm babies they could provide enough time for steroids to be given to speed the maturity of their immature lungs. Examples of this are magnesium sulphate, terbutaline and nifedipine.
  5. Limiting physical activities: Your doctor may advise you to limit certain activities or exercises that may put a mother at risk of preterm labour.
  6. Managing chronic conditions: conditions such diabetes or high blood pressure, hypertension, can increase the risk of preterm birth. This risk is decreased with effective management of chronic disorders.
  7. Limiting sexual activity: sexual intimacy can lead to contractions so if a woman is at risk of preterm birth restricting sexual activity increases the chance of a longer pregnancy.
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