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Tuesday, 10 May 2011

Premature labour

One of the many concerns I often get asked is will my baby come early? The question should actually be will my baby be premature or preterm. Labour anytime before 37 weeks would be considered as premature. It is common for the baby to come between 37 and 40 weeks but this is not a problem. The incidence of preterm labour is about 12% of all pregnancies. The most common causes are infections eg strept B, trauma to cervix eg after an abortion or cone biopsy, multiple pregnancies, poor nutrition, inadequate rest, chronic medical illnesses eg asthma. In a large number, the cause is unknown. The preterm labour tends to recur with each pregnancy.

Your obstetrician may want to perform a vaginal scan in the early or late second trimestor to determine the length of your cervix if there is a history of preterm labour or other risk factors. A short cervix ( between 10-21mm ) indicates a high risk of preterm labour.

Rest and good nutrition are very important. It is my practise to start the pregnancy with utrogestan as very often early threatened miscarriage and later preterm labour are associated with a lack of the pregnancy hormone, progesterone. Utrogestan is micronised progesterone and is very safe for use in pregnancy. I will continue this until 36 weeks. I have many patients with recurring miscarriages and preterm labour, when put on utrogestan achieve a full term and healthy baby. Tocolytics such as ventolin can be added if there are signs of excessive uterine contractions or impending labour.It also appears that consuming moderate amounts of  fish prevents preterm labour and tends to prolong the pregnancy in a recent study.

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