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Premature
Labour
Carrying a baby in your womb for
nine whole months seems a long time. But this is the time the foetus needs
to develop into that perfect bundle of joy that emerges in the delivery
room. While some babies are content to linger in the security of their
mothers' wombs, others seem to be in a rush to get out into the world.
These premature babies soon discover that nature has ordained a nine month
gestation period for a reason. They are often not physically mature enough
at birth and are sometimes born with health complications as a result of
the fact that they have not developed fully.
Premature labour is one of the most
common complications of pregnancy. Labour is termed premature when:
-
The infant weighs less than 5 ½
pounds at birth
-
The infant is delivered before 37 weeks
of pregnancy
The onset of premature labour is marked
by menstrual-like cramps, clenching of the stomach muscles, dull ache in
the lower back, pressure in the lower back, pelvis, abdomen and thighs,
and intestinal cramping.
The causes of preterm labour have
been difficult to identify. Some factors that seem to increase the likelihood
of premature labour are: multiple birth, hydramnios, abnormalities in the
structure of the uterus, smoking, inadequate weight gain in an underweight
mother, bleeding before labour, intrauterine growth disturbance, intrauterine
foetal death, eclampsia and pre-eclampsia and infections.
Once a woman goes into premature
labour, the doctors are in a dilemma whether to stop the labour or allow
it to continue. They have to weigh the risks to the health of the mother
as well as the well-being of the baby in the balance. Obviously, the ideal
situation would be if the mother could carry the baby to term so that the
foetus can mature in its natural environment. Thus, if the doctors are
of the opinion that the uterus, placenta, etc. is in working condition
and can nourish and protect the baby, they opt to stop the labour. Halting
the labour is a delaying device that doctors often use to allow the baby's
lungs to develop. Once they stop the labour, doctors can administer cortisone-like
steroid hormones to the mother that induce the lungs of the foetus to mature.
It has been found that these steroids reduce respiratory problems in babies
born after only 28 to 32 weeks of gestation.
The doctor will react to the first
signs of premature labour by ordering strict bed rest and increased fluid
intake. If premature labour begins after just twenty weeks of pregnancy,
drug therapy may be used to arrest labour and may be continued for as long
as thirty six weeks. Labour-stopping drugs include magnesium sulfate, indomethacin,
and beta-adrenergics like ritodrine and terbutaline. However, drug therapy
may not be effective in all cases.
If the doctors fail to arrest premature
labour, they make every effort to ensure a safe delivery. The foetal heart
rate is closely monitored for any signs of foetal distress. An episiotomy
may be performed to relieve the pressure on the baby's delicate skull and
bones.
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