Premature birth: definition, causes and symptoms

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The concept of preterm birth or preterm delivery according to the WHO refers to that birth that occurs before the 37th week of pregnancy. Generally, the consequences and complications of a premature birth are less how much more developed the newborn is, that is, a premature delivery of 36 weeks carries less danger to the baby than one that occurs at 34 weeks.

Below you have an index with all the points that we will discuss in this article.

Index

Premature delivery: definition, causes and symptoms

What is premature birth?

A premature birth is a complication at the obstetric and neonatal level since it can cause serious health problems in the mother and the newborn. In the most severe cases, an extreme premature delivery can lead to the death of the newborn.

Depending on the time of pregnancy in which it occurs, premature births are classified as:

  • Extreme prematurity: premature birth before week 28.
  • Severe premature delivery: between week 28 and 31 of gestation.
  • Moderate prematurity: delivery occurred between weeks 32 and 33.
  • Preliminary or limited premature delivery: from week 34 to 36.
Classification of premature birth

Causes

It is estimated that around 5-10% of births occur prematurely. Although in some cases it can be suspected what causes premature birth, in most cases the exact etiology is quite confusing.

Some of the most common causes related to the birth of a premature baby are:

  • Uterine overdistention: loss of muscle tone of the uterus that prevents this organ to return to its natural size.
  • Uterine infection or inflammation: certain bacterial components can damage the fetal membranes causing rupture and triggering premature labor. An infection that specifically affects the uterus can also cause a preterm delivery.
  • Decline hemorrhage: is a type of vaginal bleeding that can occur during pregnancy.

Although a woman does not present any complications during the development of pregnancy and follow all the necessary care during pregnancy, it is possible that premature delivery is triggered, because unfortunately this complication can occur spontaneously.

Risk factor's

There are a number of known risk factors that can increase the possibility of a preterm birth. However, it is considered that more than half of this type of births occur in pregnancies that do not present any identifiable risk factor.

It is important to analyze the risk factors according to the nature of each of them: maternal or gestational.

Maternal risk factors

Certain conditions in a pregnant woman can increase the threat of premature delivery. Some of them are:

  • Unhealthy life habits in pregnancy.
  • Obesity or excessive weight gain in pregnancy.
  • Suffer infectious processes.
  • Having previously suffered a premature delivery
  • History of surgery on the cervix or conization.
  • Arterial hypertension.
  • Belonging to the black or Hispanic race.

Gestational risk factors

Some conditions during pregnancy can facilitate premature birth, such as:

  • Multiple pregnancy.
  • Polyhydramnios: excessive presence of amniotic fluid.
  • Breaking the bag prematurely.
  • Cervical insufficiency: the cervix does not remain closed.
  • Bleeding in the first trimester.
  • Defects in the placenta: premature detachment or placenta previa.

symptom

For the diagnosis of a premature birth it is important that the pregnant woman is attentive to any warning symptom. If any of these conditions is experienced before week 37, it is important to contact the doctor:

  • Regular contractions of between 15 seconds and two minutes every 15 minutes or less.
  • Ejection of the mucous plug.
  • Increase and / or changes in vaginal discharge.
  • Vaginal bleeding.
  • Abdominal pain.
  • Increase in pressure of the pelvic area.
Symptoms of premature birth

On certain occasions, the woman may have a feeling of anxiety or uneasiness along with chills or even an increase in body temperature.

In any case, it is important that the nervousness does not take over the situation and, in case of any suspicious symptom, consult with the gynecologist or midwife.

Diagnostic tests

When a woman has symptoms of preterm labor or is in danger of having it, there are two medical tests that can be performed to confirm the diagnosis:

Measurement of the cervix

The cervix is ??a small cylinder-shaped canal that connects the uterine cavity to the vagina. As the pregnancy develops it becomes shorter, going from measuring an average of 25 mm, to "erasing" (disappearing) in the moments prior to delivery.

When the doctor suspects that the patient may be at risk of premature delivery, the length of this channel can be measured by a transvaginal ultrasound, which allows a more accurate visualization and measurement of the cervical length.

If the length of the cervix is ??reduced and there is no urgency to advance delivery, the obstetrician may consider administering progesterone via the vagina and / or perform a cervical cerclage that obstructs the area.

Detection of fetal fibronectin

Fetal fibronectin is a protein produced by fetal membranes that allows them to adhere to the uterine wall. A vaginal smear is performed to measure this protein.

If the test detects that the amount of fetal fibronectin is normal, delivery probably does not occur within two weeks. If, on the contrary, the fibronectin concentration is abnormally high, there is a risk of premature delivery. However, it is not a definitive test and it is important to take into account other factors such as gestational age or size of the baby in order to establish a treatment.

Treatment for possible premature birth

Whenever possible, the first strategy is to delay birth so that the fetus can continue to grow and develop normally. However, many premature births are inevitable and are provoked to avoid worse consequences.

In the face of a slight threat of premature delivery, absolute rest of the pregnant woman is advised, since staying in bed decreases the pressure on the uterus and the cervix as well as the probability of contractions. It is recommended that the woman try to stay hydrated to increase the concentration of blood in her body and try to reduce stressful situations or activities

In the most risky cases, where the woman is admitted to the hospital, serum is administered intravenously so that it is as hydrated as possible. In addition, it is possible for the doctor to provide drugs called tocolytics to slow labor.

With regard to the child, one of the most common complications in the birth of a premature baby is that his lungs are still too immature and can suffer serious respiratory problems. To avoid this, pregnant glucocorticoids are administered to stimulate the maturation and growth of the fetal lungs. It is necessary that the gestation has passed at least 24 weeks of development to be able to deliver this medication.

Premature babies and special care

A premature birth can pose certain health and development problems for premature babies, since the last 8 weeks of pregnancy is the key period during which the fetus experiences its greatest growth.

As we mentioned before, the problems of the respiratory system are the most common in this type of newborn, since the lungs are one of the last organs to develop. It is also common that they may have problems in the digestive, renal or immune system, as well as in vision.

Because of all this, premature babies need a series of special care such as assisted ventilation, application of heat (because of their prematurity have problems to retain body heat) or receive food intravenously, since they do not coordinate suction correctly, swallowing and breathing

For this reason, it is not possible for a premature baby to receive nursing care at home, since medical equipment is needed and this implies the stay of the baby, during a more or less prolonged period, in the ICU of neonates.

If you want to know more about the characteristics of premature babies, visit this link: Premature babies.

Questions from users

Do they give you the same sick leave when a premature birth occurs?

Generally yes, the same permission is granted after a normal delivery or a premature delivery. However, a threat of premature birth is a reason for sick leave, which can be prolonged with maternity leave.

What kind of food should a premature baby bring?

According to experts, breast milk is the best food for newborns and especially premature babies. However, in the case of premature babies, unable to suck properly, it is necessary that the food is introduced through nasogastric or stomach tubes. Occasionally, due to the consequences of the prematurity of his birth, it is necessary to supplement his diet with iron.

What weight was the smallest premature baby in the world?

There are many cases of premature babies in the world that, fortunately, have managed to survive. One of the most striking cases is that of a girl, Amilia Taylor, who was born in a hospital in Miami at 22 weeks of gestation and weighing 280 grams.

Can a premature baby be born by natural birth?

Yes, it is possible that a forward delivery occurs through the vaginal canal. That is, it is not necessary to always perform a cesarean section in the case of premature delivery.

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