Premature birth occurs when the baby is born before 37 weeks of gestation, which can happen due to several causes, from uterine infection, premature rupture of the amniotic sac, placental abruption or diseases related to the pregnant woman’s health, such as anemia or preterm birth. eclampsia, for example.
Normally, premature birth can be identified through some signs and symptoms such as frequent and regular uterine contractions, increased vaginal discharge and a feeling of pressure, or pain, in the pelvic region. In these cases, it is important that the pregnant woman goes to the hospital as soon as she experiences these signs and symptoms, as premature labor can pose risks to the baby, especially if the gestational age is very low.
When faced with premature labor, the doctor may try to postpone the birth using medications and techniques to prevent uterine contractions and dilation, however, it is difficult to postpone the birth for more than 48 to 72 hours. In the case of a premature baby being born, it is common for them to stay in the neonatal ICU so that their development can be monitored and complications can be prevented.
Signs and symptoms of premature birth
A pregnant woman may suspect that she is going into premature labor when she presents signs and symptoms such as:
- Frequent and regular uterine contractions;
- Pressure in the bottom of the belly;
- Increased urge to urinate;
- Increased vaginal discharge, which becomes gelatinous and may or may not contain traces of blood;
- Pain in the lower back;
- Intense colic.
If a woman experiences these symptoms before 37 weeks of pregnancy, it is important that she call her obstetrician or go to the hospital to be evaluated. Typically, the doctor orders a transvaginal ultrasound to evaluate the size of the cervix, as well as an analysis of vaginal secretion to identify the presence of fetal fibronectin, a protein that helps confirm the risk of premature birth.
A measurement above 30 mm on the cervix indicates a greater risk of delivery within 7 days and women who present this value should be evaluated for fibronectin. If the woman measures between 16 and 30 mm but has negative fetal fibronectin, there is a low risk of delivery; however, when fetal fibronectin is positive, there is a risk of delivery within 48 hours.
Possible causes
Premature birth is more likely to occur in women over 35 years of age or under 16 years of age, as well as in women who are pregnant with twins, have had a previous premature birth or are losing blood in the third trimester of pregnancy.
Furthermore, other situations that can cause premature labor are:
- Premature rupture of the amniotic sac;
- Weakening of the cervix;
- Bacterial infection Streptococcus agalactiae (group B streptococcus);
- Placental abruption;
- Pre-eclampsia;
- Anemia;
- Diseases such as tuberculosis, syphilis, kidney infection;
- Twin pregnancy;
- Carrying out in vitro fertilization;
- Fetal malformation;
- Intense physical effort;
- Use of illicit drugs and alcoholic beverages;
- Presence of myoma in the uterus.
Furthermore, pregnant women with a history of vaginosis also have a higher risk of premature birth, because some bacteria can release toxins and promote the release of cytokines and prostaglandins that promote labor. Some foods and medicinal plants can also promote uterine contraction and stimulate premature labor and are therefore contraindicated during pregnancy. Check out a list of teas that pregnant women should not consume.
Main complications
Complications of premature birth are related to the gestational age of the baby at birth:
- Baby at 23 to 25 weeks: most cases can develop serious disabilities, such as cerebral palsy, blindness or deafness;
- Baby at 26 and 27 weeks: some babies may develop moderate disabilities, such as visual impairment, lack of motor control, chronic asthma, and difficulty learning;
- Baby 29 to 31 weeks: Most babies develop without problems, but some may have mild forms of cerebral palsy and visual problems;
- Baby at 34 to 36 weeks: Premature babies develop in a similar way to those born within their due date, but are more likely to present development and learning problems.
Generally, prematurely delivered babies are placed in an incubator as they are not able to maintain their body temperature. Thus, this device maintains temperature and humidity similar to the uterus, allowing its development.
Babies under 34 weeks of gestation may still be connected to a breathing apparatus, as before 34 weeks of gestation they lack surfactant, a substance that facilitates the entry of air into the lungs and therefore signs such as a bluish color may appear. nails and fingertips and lips.
Furthermore, premature babies are at greater risk of retinopathy, which reduces visual ability, which is why all premature babies need to wear a blindfold while in the neonatal ICU. The baby is only released home when he reaches 2 kg and when his organs are more developed, so that he can swallow without a tube and breathe without the help of equipment.
How to avoid premature birth
To avoid premature birth, what a pregnant woman can do throughout her pregnancy is to avoid excessive physical activity and follow all the obstetrician’s instructions during prenatal consultations.
However, if labor begins earlier than expected, the obstetrician may recommend the use of medications such as corticosteroids or oxytocin antagonists, which can be used between 25 and 37 weeks of gestation. These techniques to avoid premature birth must be carried out while admitted to the hospital and applied according to the benefits for the mother and baby.
