Preventing Premature Birth – Every Day Counts

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Dr. Thewin Dejthevaporn is an obstetrician and gynecologist at Samitivej Sukhumvit hospital specializing in maternal fetal medicine with expertise in antenatal care and delivery and high risk pregnancy management including ultrasound for diagnosis of fetal abnormality and prenatal diagnostic procedures. Make sure to read the entire series!

You may also be interested in the following article, also written by Dr. Thewin: Your Pregnancy Has Been Labeled ‘High Risk’ – Now What?

About 10% of all pregnancies result in premature birth, and premature birth means increased risk of serious complications and, sometimes, infant deaths. If a doctor can prolong the pregnancy even a week, it can significantly increase the chance of saving the newborn. After the completion of 26 weeks, each day the pregnancy is prolonged can reduce the risk of death by 2%.

Delivering a baby before completing 37 weeks is premature. It is considered a safe time to deliver a baby with no health issues after a full term pregnancy or 37 complete weeks. Normally if we’re healthy and have never given birth before we just assume that this isn’t going to be our problem. Most likely you’re right, it won’t be, but it’s still important to know and be aware as sometimes even a healthy pregnant woman and by healthy we mean, those who are not over 35 or under 18, carrying multiple babies, smoking, drinking or eating poorly, could have premature contractions. It could happen to anyone. What mothers need to understand is that sometimes no matter how carefully they are monitored and no matter how carefully they follow instructions, they may go into premature labor.

Prevent premature birth

The exact cause of preterm labor is still largely unknown. Medical science doesn’t completely understand why some women go into labor or break their water early. There’s no completely accurate way to predict who will end up with premature labor. However we do know that of all the predictors of preterm birth, past obstetric history may be one of the strongest signs of a recurrent preterm birth. The risk of recurrent preterm birth after 1, 2, and 3 consecutive preterm births may be increased to approximately 15%, 30%, and 45%, respectively. Other significant reasons for preterm birth could be an infection, carrying multiples babies, an abnormally short cervix or a combination of these or more factors. If you are in one of the above categories, your gynecologist is likely to call your case a high-risk pregnancy. This label isn’t intended to stress you out; it just means you’ll be given extra monitoring or care during your pregnancy.

Every practitioner uses and every high-risk case demands its own treatment and care, but on the general side you’ll be encouraged to take special care of yourself. You should eat well, get plenty of rest, manage your stress level, start your prenatal care early and see your practitioner regularly. In addition to a healthy lifestyle your doctor may choose to use progesterone to prolong your pregnancy. The progesterone hormone made in your body helps you become and stay pregnant. Taking extra natural or synthetic progesterone weekly, starting at 16 to 20 weeks and continuing through 36 weeks, has proven to significantly reduce the risk of a preterm delivery, particularly for women who had a preterm birth in the previous pregnancy as well as women with a short cervix. Progestogens can be given as a gel, cream, capsule, as a shot in your arm or other muscles or as suppository that you place in your vagina.

When it gets closer to the due date, take time to tune into the changes that are happening in your body. Knowing the symptoms and avoiding particular risk factors allows a mom-to-be to reduce her chance of going into labor prematurely. Pay attention to any unusual aches or pressures. If you notice more or a watery or blood tinged vaginal discharge, call your doctor. Abdominal pain, cramps, more than four contractions in an hour, and pressure in the pelvic area are all symptoms for premature labor. Even if they do not hurt, inform your doctor immediately. Sometimes it takes just a couple hours before your body becomes ready for labor, so let your doctor prevent that from happening. We understand that it can be confusing and difficult to differentiate between signs of premature labor and the pressure and pain which can be normal during pregnancy, but when you’re not sure it’s always better to be on the safe side. In the meantime, while waiting for your doctor, empty your bladder, drink several glasses of water and lie down tilted towards your left side to slow down or stop labor symptoms.

Looking for a doctor for your pregnancy health questions? We recommend:
Thewin Dejthevaporn, M.D.Thewin Dejthevaporn, M.D.
OB/GYN, Samitivej Hospital
Questions about your pregnancy, child birth or life with an infant? Ask the Doctor!

If you’re found to have preterm labor, depending on your condition the doctor will decide what to do. Normally if you haven’t completed 37 weeks, your practitioner will do whatever is safe and possible to prolong the pregnancy and give the baby more time to mature. The longer your baby is in the womb, the better the chance of he or she being healthy. Specialists may give you antibiotics to lower the risk of possible infections and a course of corticosteroids to help hasten your development of your baby’s lungs, the last organ to mature. Some women with signs of premature labor and early dilation of the cervix are put on bed rest until the pregnancy progresses.

If none of that works, and if premature deliver is necessary, you still need not worry. Neonatal intensive care units exist specifically to provide a newborn the best possible care. A diagnosis will be made depending on the baby’s age, weight and ability to breathe. He/she will probably be put in an incubator as this environment keeps the baby’s temperature stable and also decreases the risk of an infection. The humidity is also controlled to maintain the baby’s hydration. There will likely be tubes and wires attached to the baby but it is only to constantly monitor breathing, heart rate, blood pressure, and temperature. Some babies are initially fed intravenously until they can eventually be given breast milk.
Samitivej, We Care!

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181

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