What are preterm labor contractions?
Premature contractions are so-called opening contractions that begin before the expected date of birth. Contractions of the smooth muscles of the uterine wall (uterine muscles) cause the cervix to open. Only such cervix-acting contractions are actually true preterm labor. If the baby is born before the 37th week of pregnancy due to premature labor, this is called a preterm birth.
Recognizing preterm labor
How does the doctor diagnose preterm labor?
In the doctor’s office or clinic, the doctor will use various examinations to determine whether you have actually gone into preterm labor. First, the gynecologist will check whether – or how wide – the cervix is open. The ultrasound examination helps to determine the length of the cervix and allows a look at the baby. You can also tell if the baby is doing well by looking at the labor recorder (cardiotocograph, CTG), which records the baby’s heart sounds as well as the strength and frequency of the premature contractions.
Even if your doctor diagnoses you with preterm labor, this does not automatically indicate the onset of preterm birth. The cause of preterm labor plays a role in this.
Reasons for preterm labor
Risk factors for preterm labor include:
- previous preterm birth or miscarriage
- Multiple pregnancy
- malformations and maldevelopments of the child (open back = spina bifida), the placenta (placental insufficiency), the cervix (cervical insufficiency) or the uterus (myomas)
- Too much amniotic fluid (hydramnios)
- maternal diseases: Vaginal infection, pregnancy-related high blood pressure (preeclampsia), diabetes mellitus, fever, depression
- unfavorable social living conditions: poor school education, unemployment, single, unwanted pregnancy
- unhealthy lifestyle of the mother: nicotine, alcohol, malnutrition or malnutrition
- age of the pregnant woman under 18 years or over 35 years of age
Treatment of premature labor
Especially in the case of premature labor before the 34th week of pregnancy, it is crucial for the prognosis of the child that some more time is gained. At this stage of pregnancy, the development of the child’s lungs is not yet complete. Therefore, to prevent complications after birth, lung maturation must be accelerated. For this purpose, the doctor will give you cortisone (glucocorticoid). It may also give you anti labor medications to buy valuable time. If the situation is serious, your doctor will refer you to a hospital (perinatal center) that specializes in premature births.
Overall, depending on how severe and effective preterm labor is and at what point in the pregnancy it occurs, different treatments may be considered.
- Inhibitors of labor (tocolytics): these inhibit preterm labor. However, due to cardiovascular side effects, they may only be taken between the 24th and 34th week of pregnancy and for a maximum of two days.
- Relaxation: e.g. stress reduction, autogenic training, hypnosis, one-on-one psychological counseling, sedation, bed rest, less physical activity, etc.
- No sexual intercourse: prostaglandins contained in semen promote labor.
- Antibiotics for vaginal infection: tablets or vaginal suppositories if bacteria are detected after vaginal swab.
- Magnesium sulfate: It may prevent preterm labor, but is controversial due to side effects.
- Cervical suture/pessary: A suture or silicone ring closes and stabilizes the cervix. The method is applicable for cervical shortening, not after SSW 28.
