Signs of preterm labour
APART from the desire for a happy, healthy pregnancy, all women anticipate carrying their babies to full term, which is described as between 38-40 weeks of pregnancy. And while approximately 90 per cent of women will hit this mark, unfortunately, the remaining 10 per cent will experience labour prematurely, and this may result in babies being born earlier than is ideal.
Obstetrician-gynaecologist at ICON Medical Centre Dr Keisha Buchanan, who has seen her fair share of preterm births, describes why it occurs, associated risks, as well as some of the most common warning signs that you are in preterm labour.
“Preterm labour is the onset of regular contractions of the womb that results in dilation of the cervix, which occurs between 24 weeks of pregnancy to 37 weeks. While many preterm babies have a very good chance of survival with some intervention, in births before 34 weeks there is a high possibility of health complications because the foetal lungs are unlikely to be developed and the risk of respiratory distress is high, which can lead to morbidity in the newborn,” Dr Buchanan explained.
She pointed out that premature labour may be triggered by infections such as bacterial vaginosis, chlamydia and gonorrhoea. She underscored that this is why abnormal discharge or signs of a bladder infection such as burning during urination, odour, or blood in the urine often precede premature labour.
“Other issues that may trigger or predisposes you to premature labour is the presence of fibroids, multiple pregnancies, and pre-existing uterine deformities — for example, arcuate uterus or bicornuate uterus,” Dr Buchanan said.
Below, Dr Buchanan shares signs of premature labour:
1. Prior to the onset of labour, the mucous plug dislodges. The mucus plug is jellylike, blood-tinged or streaked with brownish blood which, when passed, is referred to as a show.
2. “Some women will have only intermittent back pains. These may start every one to two hours apart and get closer over several hours,” Dr Buchanan said. She explained that labour is present when the pains are 10 minutes apart or closer, and advised that women should seek medical attention when the pains are mild and not very close apart, for example every 20 to 30 minutes apart. She said that the earlier medical attention is sought, the earlier the medical team can start treatment to prevent established labour.
3. Pelvic pressure is also another common sign and involves usually a sudden or a gradual feeling of heaviness and even pain in the pelvic region.
4. The passage of water vaginally or an increase in vaginal discharge may indicate that the water is broken. While some people may experience a gush, for others it may seem like a leak.
5. If contractions — which are described as the uterus tightening then relaxing — are regular, feel very strong and last more than 30 seconds, it means labour may have started. If they persist it’s best to rest and drink two to three glasses of water, but if it is getting more frequent or continues to persist, it is best to go to the hospital, if they do not resolve after an hour, for evaluation. However, if the woman has a prior history of premature labour that resulted in a premature delivery, she should seek medical attention sooner.
Some natural occurrences such as Braxton Hicks contractions in the third trimester of pregnancy may mimic premature labour, according to Dr Buchanan. She notes that it is important to pay close attention to contractions since most contractions which occur are most likely Braxton Hicks, which are contractions which occur before real labour begins. These are irregular, mild, painless uterine contractions that last 30 seconds to up to two minutes.
“If these contractions are short-lived, it will not progress to the real labour. They occur with increasing frequency in the third trimester, but never just brush them off; they should be closely monitored to ensure that it is not the onset of real labour,” Dr Buchanan advised.
