Health Information

Summary/Definition

Premature birth is called childbirth that occurred between 20 and 37 weeks of pregnancy, which is approximately 6-15% of all births. Premature birth is the main cause of neonatal mortality and is highly likely to lead to complications that may occur in the future, for example, neurological disorders or respiratory disorders. The exact cause of premature birth is unknown, as they are not caused by one specific cause. Risk factors include smoking, psychological and physiological stress. It is important to undergo prenatal testing and find ways to prevent premature birth.

Depending on the cause, premature birth can be divided into premature birth through the natural birth canal, premature birth due to premature rupture of the membranes and cases when premature birth is caused artificially for medical reasons for the treatment of pathologies of a pregnant woman or fetus. Among them, natural premature birth and premature birth due to premature discharge of amniotic fluid account for more than 75% of all premature births. Natural premature birth is the largest proportion of premature births, therefore, interventions such as the use of drugs are used to prevent or treat them. The reasons that increase the risk of premature birth include a history of premature birth, premature discharge of amniotic fluid, uterine atony, bleeding during pregnancy, the mother’s lifestyle (smoking or using illegal drugs, etc.), genetic factors, infections, abnormalities of uterine development, multiple pregnancies.

Symptoms

In the case of premature birth, the increasing dynamics and intensity differ, as well as the subjective symptoms felt by the mother differ. In preterm labor requiring clinical treatment, the pain is regular and prolonged, increases over time and may be accompanied by vaginal bleeding or premature discharge of amniotic fluid. Pain with similar symptoms is a normal phenomenon and does not require hospitalization or treatment, since it does not lead to contractions, so it is necessary to distinguish between premature birth and pain. It is sometimes difficult for a mother to independently distinguish false contractions from the onset of premature labor, therefore, if she feels any abnormal signs, she should immediately visit the hospital for examination.

Diagnostics

In about 30% of mothers, uterine contractions disappear on their own after hospitalization, and about 50% of them do not lead to premature birth and often give birth to full-term babies after 37 weeks of pregnancy, so it is difficult to distinguish pain at the beginning of contractions only from symptoms. Therefore, an examination of the cervix, ultrasound examination, examination of biochemical markers, etc. is carried out. The cervix is examined for the opening of the cervix, whether it is thinned and whether there is amniotic fluid, as well as ultrasound to check the weight of the fetus, its position, posture, placenta previa, the amount of amniotic fluid and the length of the cervix. Biochemical marker tests determine the presence of fibrous connective tissue of the fetal part of the placenta in the cervical canal.

Treatment and course of the disease

There is still no ideal treatment to prevent premature birth, various drugs are used to prolong pregnancy and improve the prognosis of premature babies. Drugs also have side effects, so the decision on their use should be made taking into account the condition of the mother. Drugs such as steroids, progesterone, inhibitors that enhance uterine contractions, antibiotics, etc. are used. Steroids promote the maturation of fetal lungs, and progesterone prevents premature birth. Uterine contractions can be suppressed with beta-blockers, sympatholytics, calcium channel blockers, oxytocin antagonists, magnesium sulfate, etc., and antibiotics can be used to prevent bacterial infections of group B in newborns.

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