Preventing preterm labour

A normal pregnancy lasts nine months, or about 37 – 40 weeks. However, pregnancy can be a time of uncertainty, including the possibility of preterm labour and birth. According to Dr Keisha Buchanan, obstetrician-gynaecologist at ICON Medical Centre, this can be triggered by maternal or medical issues associated with the baby.“Premature birth occurs when a baby is born between 20 weeks and 37 weeks of gestation. Hence a pregnancy that occurs three weeks or up to five months before the due date is premature,” Dr Buchanan said.What are some of the causes of premature labour? These include prior premature births and multiple pregnancies – for example, twin or triplet pregnancies. Dr Buchanan also identified pregnancy-related complications such as gestational diabetes and preeclampsia, vaginal bleeding in pregnancy, such as those due to a low-lying placenta (placenta previa), as well as short intervals between pregnancies which don’t give the body sufficient time to heal.Non-pregnancy medical factors such as surgeries on the cervix – for example, a loop excision to remove cancerous cells, chronic illnesses such as high blood pressure or diabetes, kidney disease, being born with abnormalities of the womb, recurrent bacterial vaginosis (a vaginal infection), and recurrent bladder infections are also to blame.Dr Buchanan cautioned women that lifestyle choices can also significantly increase the possibility of preterm labour.“Lifestyle-related factors such as cigarette smoking or other illegal drug use, poor nutrition, obesity or being underweight, and sexually transmitted diseases in pregnancy, such as chlamydia and gonorrhoea, should always be avoided,” Dr Buchanan warned.She pointed out that while women may not always have control over their medical situations, there are ways of preventing premature labour if optimal control is exercised.1. Manage your weight properly“It is important to get all medical conditions properly managed prior to pregnancy; for example, optimise pre-pregnancy weight. This will help to decrease morbidity for both mother and foetus, optimise the pregnancy outcome, and prevent premature birth. If necessary, seek the assistance of a nutritionist, and exercise to lose weight. However, if you decide to do it on your own, always consult your physician before starting a weight-loss regimen,” Dr Buchanan advised.She also advised women struggling to gain weight to consult their doctor, because conditions such as thyroid disease may make it hard to gain weight and can increase the risk of premature birth if not treated. 2. Avoid all drugs and alcoholFor pregnant women or women trying to become pregnant and struggling with drug or alcohol addiction, Dr Buchanan advised serious commitment to getting clean.“Addiction and rehabilitation centres offer many benefits to addicts. We always encourage women that all drug use should be stopped prior to the pregnancy. Drug and alcohol addiction during pregnancy can cause defects and other medical conditions such as foetal alcohol syndrome,” she cautioned. 3. Take care of all vaginal infections immediatelyAnother way of warding off preterm labour is to seek medical attention during the pregnancy if symptoms of a vaginal infection develop, such as an abnormal discharge or vaginal odour, irritation or itching.“Most vaginal infections will not increase the risk of premature labour, but some infections such as bacterial vaginosis (not sexually transmitted) and sexually transmitted infections such as trichomoniasis, chlamydia, gonorrhoea, and mycoplasma can increase this risk. However, early detection and treatment will help to prevent premature delivery,” Dr Buchanan said.She also recommended that women at high risk of these infections should be screened for them early in pregnancy, and treated if positive. 4. Space pregnancies“It is important to space pregnancies at an interval of 18 months to five years from the birth of one child to the conception of the other,” Dr Buchanan advised. She recommended the use of long-term contraceptive methods such as the intrauterine device (the coil) so you won’t have to rely on memory in an effort to prevent unplanned pregnancies.5. Address cervical concerns as necessary“The application of the cervical cerclage, which is a stitch placed by the obstetrician in the pregnant woman’s cervix at three months under anaesthesia, is to treat cervical incompetence or insufficiency,” Dr Buchanan said. In addition to this, she says some women may require hormonal support such as vaginal progesterone. 6. Stick to a healthy, balanced dietDr Buchanan said that proper nutrition is important throughout pregnancy. “It is essential to take the prenatal vitamins daily and any additional iron that may be prescribed, as deficiency of certain nutrients can increase the risk of premature delivery,” she advised. 7. Start seeing an ob-gyn early“Most importantly, prevention of premature delivery can be started with going to see your obstetrician from early in the pregnancy, such as within the first one to two months of the pregnancy,” Dr Buchanan said. She advises expectant mother to fully comply with antenatal visits to avoid complications of pregnancy and childbirth.