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Premature Labor

Premature labor is part of a high risk pregnancy as it leads to a premature baby. Infant death is higher in premature babies due to a multitude of complications.

The main complications are hypoglycemia, the risk for infection is increased and there is also an increased risk for hemolytic anemias and newborn jaundice. A variety of conditions can lead to premature labor such as a fever, multiple pregnancies, uterine abnormality, an incompetent cervix that opens up too early, just to name a view.

Smoking while pregnant will often also lead to premature labor. (Ref. 20, p.2036). When premature labor occurs, immediate hospitalization is necessary and an attempt will be made to stop the labor. If this is unsuccessful, or if there is premature water break (premature rupture of the membrane) , the baby will be born prematurely.

Most premature infants born after 28 weeks survive with specialized care in a premature nursery, but there are a number of high risks and possible complications. It follows from this that prevention of premature labor is a highly effective method of preventing a lot of fetal and early infant mortality.

The methods are simple enough:

1. no smoking

2. no recreational drugs

3. avoid fever and have this treated immediately by the treating physician.

4. Have balanced nutrition with regular meals, pregnancy is no time for crash diets.

5. Diabetes treatment needs to be followed vigorously with close supervision by a physician and dietician.

All of this is common sense and relatively easy to follow.

There are a few other problems to consider: Women above the age of 35 are more likely to get conditions like arthritis, diabetes, obesity, and this can lead to complications with their pregnancy. But this website states that these conditions can be medically managed so that risks of pregnancy at age 40 are not any worse than at age 35. Risk  for prematurity can come from  declining fertility on behalf of the woman with increasing age, but a desire to want children at a later age. This leads to a rise of fertility clinic visits, lengthy and costly procedures to get pregnant, and finally a risk for twins or triplets, which is the reason for more premature labor and premature babies. Seeing these connections it would be logical to have children in the 20’s when child-bearing is a lot easier for the couple, but common sense is often pushed aside because of career aspirations.

It is because of these latter facts that the US and many of the industrialized countries will have a hard time to get a grade A on the report card of prematurity.

Prenatal visits are an important part of preventing the complication of a preterm delivery. Read more about prenatal visits here.

More info about March of Dimes (a non- profit organization).

 

References:

1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 235.

2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper  Collins, 1997.

3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby,  Inc.

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 245.

5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.

6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.

7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B.  Saunders Company

8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B.  Saunders Company

9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.

10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B.  Saunders Company

11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.

12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B.  Saunders Company

13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.

14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.

15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby,  Inc.

16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams &  Wilkins

17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC

18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed.,  1996 Churchill Livingstone, Inc.

19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 251.

20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse  Station, N.J., 1999. Chapter 250.

21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die  Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and  Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.

22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th  ed., 1998 Mosby-Year Book, Inc.

23. Mandell: Principles and Practice of Infectious Diseases, 5th ed.,  2000 Churchill Livingstone, Inc.

24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.

25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last modified: November 8, 2014

Disclaimer
This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.