How to tell it's premature labour

 

Any expectant mother would love to carry her pregnancy to term, but some women for various reasons experience pre-term labour, thus giving birth to pre-term babies.

 

Dr. Christine Seremba, the area manager of paediatrics at Mulago Hospital, says pre-term labour is when a woman starts having contractions after the 20th week of pregnancy and more than three weeks before she expects to deliver. The contractions cause the cervix to open earlier than normal. 

 

However, pre-term labour can be stopped to allow the baby more time to mature and develop in the uterus. This can be done by encouraging bed rest, administering fluids intravenously (through the veins) and medications that relax the uterus.

 

 

Dr. Tito Bayeze, the acting executive director of Mulago Hospital, says pre-term labour is unusually painful and there are several warning signs. 

 

These include lower backache that may be sporadic, menstrual-like cramps or lower abdominal cramping that may feel like gas pains — with or without diarrhoea and contractions in the uterus every 10 minutes or less. 

 

A mother can check for contractions by placing her fingertips on the abdomen and if she feels the uterus tighten and soften, she needs to record how often the contractions happen; that is, at the beginning of one contraction and the beginning of the next contraction.

 

Other signs of pre-term labour are increased pressure on the woman’s pelvis, increased vaginal discharge, vagina leakage and bleeding. Symptoms such as nausea, vomiting, diarrhoea and less movements or rapid kicking by the baby are other warning signs that should not be taken lightly. 

 

Seremba says immediately a woman notices unusual signs such as vaginal bleeding, or a sudden increase in vaginal discharge, she should go to a doctor right away. There is often little a pregnant women can do to prevent pre-term labour, but one must stay away from unhealthy habits such as smoking and alcohol consumption. 

 

One should also ensure she treats vaginal infections and should seek medical help in case of an abnormal discharge. 

Pregnant women are also encouraged to consult a doctor when they experience symptoms such as swollen ankles and bleeding. In addition, pregnant women are encouraged to keep fit and healthy and avoid excessive stress.

 

Bayeze says in case a baby is born prematurely, he is put in the neonatal (newborn) intensive care unit, where specialised care of ill or pre-term new-borns is provided. Here, the babies get the required diet and temperature to grow healthily and they are guarded against infections. 

 

Since most pre-term babies are born underweight, they are placed in incubators (open warmers) for respiratory support. 

Seremba says many pre-term babies are born daily in different hospitals, with Mulago, the national referral centre, having the highest number of about three to five babies, daily. 

 

These babies battle at the start of life, with a risk of many significant long-term problems that include respiratory distress syndrome and hypothermia, a condition in which the body temperature drops below the normal one.

 

Other risks include low blood glucose, jaundice (yellowing of the skin and the whites of the eyes) and infections. Abnormal blood vessel dilation in the retina and death are the other risks.

 

 

Seremba says if a baby is born after 34 weeks, the risks of suffering from complications are lowered because the baby will have almost completely matured. She emphasises that babies born before 28 weeks be delivered in a hospital with a neonatal intensive care unit.

 

 Infections in the vagina and urinary tract

 

  Multiple pregnancy

 

  Pre-term rupture of membranes

 

  Abnormalities of the uterus

 

 Previous surgery on the cervix

 

 Previous terminations of pregnancy

 

 Previous miscarriages, especially between 16 and 24 weeks

 

 Previous pre-term birth

 

 Social and lifestyle factors such as living in poverty, domestic violence, changing partners between your first two babies, taking drugs such as cannabis, smoking and drinking alcohol.