RISK OF PREMATURE BIRTH AND EARLY BIRTH
The birth before the 37th week of pregnancy is called “premature birth”. The “danger of premature birth” is the opening and thinning of the cervix, accompanied by strong uterine contractions (these contractions are felt as strong pains in the lower back and groin area) twice in ten minutes before the 37th week of pregnancy. The main causes can be counted as maternal blood pressure, heart, kidney, anemia, goiter, infectious diseases, malnutrition, smoking and alcohol use, frequent birth, previous preterm birth, excess water during pregnancy (polyhydramnios), multiple pregnancy (twins, triplets, etc.), cervical insufficiency, and anomalies that narrow the uterus. Its rate in all births is about 10%.
How is it diagnosed?
In the beginning, there are contractions and cramps similar to menstrual period. These complaints turn into pains that are felt in the waist and groin area and become more and more frequent. Some pregnant women confuse these complaints with gas pains and delay in applying to the doctor. In delayed cases, the chance of treating the risk of premature birth decreases. For this reason, pregnant women should be educated at the beginning of their pregnancy, in which cases they should urgently consult a doctor. Vaginal bleeding can also be seen along with the pain. Up to 40% of patients have an increase in vaginal discharge. In the examination, strong contractions originating from the uterus and the opening of the cervix are detected.
For early diagnosis, careful monitoring of risk-bearing pregnant women and early treatment of infections in all pregnant women are required. In addition, the length of the cervix should be measured by ultrasonography at 20-22 weeks of gestation, if this measurement is below 25 mm., it can be said that the risk of preterm birth is increased and should be followed closely.
How is the treatment done?
First of all, patients should be hospitalized. A calm and quiet environment should be provided and they should be advised to take plenty of fluids. Initially, about 1 liter of fluid is given intravenously. This precaution can sometimes relieve pain. If the pain does not subside, preventive treatment (tocolysis) for premature birth should be started. This treatment will not be effective in patients with more than 4 cm of cervix width. Therefore, early diagnosis and intervention are important. There are various drugs that can be used intravenously (ritodrine, magnesium sulfate) or orally (nidilate, prostaglandin synthesis inhibitors, etc.) for treatment. These drugs have both situations where they should not be used and some side effects. Therefore, great care should be exercised in the selection and use of drugs.
The risks that the premature baby will face is the most important problem in the danger of preterm birth. Chief among these is respiratory distress. The main risk among these is respiratory distress. In cases where there is a danger of preterm birth in the 28-34th weeks during pregnancy, steroid treatment is applied to the mother in order to contribute to the lung development of the baby in the mother’s womb and to reduce the respiratory distress that may develop after birth. Babies born before 34 weeks of gestation should be followed up in centers where neonatal intensive care conditions are very good.
We wish you all a well-timed birth…