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Preterm delivery
What are the signs of premature birth?
Under normal circumstances, during preterm labor, there may first be regular uterine contractions accompanied by continuous cervical dilation. This situation should be considered a possible onset of preterm labor. Generally, the period from after 28 weeks to before 37 weeks of gestation is considered the possible range for preterm labor to occur. Therefore, if there are symptoms like regular abdominal pain, backache, or a feeling of heaviness, it is necessary to seek medical attention promptly. When needed, local physical therapy, symptomatic treatment, or administration of medications to sustain the pregnancy can effectively alleviate the symptoms.
Does placenta previa cause preterm birth?
When a placenta previa occurs, it is likely to lead to premature birth. Placenta previa is a condition where, after 28 weeks of pregnancy, the placenta is positioned low in the uterus, often below the presenting part of the fetus, and attaches to the lower segment of the uterus or near the internal os of the cervix. In the late stages of pregnancy, dilation of the cervix can cause the placenta to be misaligned with the uterine wall, leading to recurrent, painless bleeding. When the bleeding reaches a certain amount, it can easily lead to premature separation of the placenta, inducing uterine contractions and the onset of premature birth. In cases of placenta previa with significant vaginal bleeding, it is necessary to terminate the pregnancy promptly.
Premature birth is how many weeks?
Premature birth refers to childbirth occurring before full-term pregnancy. In contrast, the terms miscarriage, full-term birth, and post-term birth are used, differentiated mainly by the gestational weeks. Miscarriage refers to the expulsion of a fetus before 28 weeks of pregnancy, premature birth refers to expulsion between 28 and 36 weeks plus 6 days, full-term birth refers to expulsion between 37 and 41 weeks plus 6 days, and post-term birth refers to expulsion after 42 weeks of pregnancy. The definition of premature birth being set between 28 and 36 weeks plus 6 days mainly stems from the fact that during this time period, the fetus already has a significant chance of survival. However, the overall survival rate is lower than that of a full-term birth. It is crucial to promptly treat the newborn in cases of premature birth, while also preventing complications in the mother.
Will early engagement of the fetus lead to premature birth?
Fetal engagement refers to the leading part of the fetus having entered into the woman's pelvis. There isn't a necessary correlation between fetal engagement and preterm birth; however, fetal engagement could indicate a possibility of preterm birth or an upcoming labor. It is important to pay attention to the timing of fetal engagement and the expectant mother's sensations post-engagement. Firstly, for the vast majority of pregnant women, fetal engagement should occur after week 32 or 34. Early engagement should prompt attention to the presence of other clinical symptoms. Secondly, be mindful if there are feelings of descent or abdominal pain after the fetal engagement. Regular checks of the cervical canal length should be conducted if these sensations frequently occur. If the cervical canal is progressively shortening, it may suggest a risk of preterm birth. If there is no shortening of the cervical canal, it means that the fetal engagement and these clinical symptoms are unlikely to cause preterm birth.
Is low amniotic fluid likely to lead to premature birth?
During pregnancy, if there is a reduction in amniotic fluid, it is easy for premature delivery to occur. Insufficient amniotic fluid can cause fetal hypoxia in the uterus, which may lead to frequent fetal movements and stimulate uterine contractions, resulting in premature birth. When there is a reduction in amniotic fluid, it is important to replenish it in a timely manner. This can be done by drinking more water, intravenous fluid infusion, or directly injecting saline into the amniotic cavity. To determine the best method to replenish the amniotic fluid, it is advisable to seek treatment under the guidance of a doctor and to closely monitor changes in fetal heart rate and movements.
Premature birth: Cesarean section or natural delivery?
Whether to opt for cesarean or vaginal delivery for preterm birth needs a comprehensive grasp of the pregnant woman's entire condition before assessing and deciding on the mode of childbirth. First, it's necessary to check if the woman has any complications and the severity of these complications, as well as whether her physical condition allows for vaginal delivery. Additionally, the changes in fetal heart rate must be considered. If the fetal heart rate is particularly poor, and the duration of vaginal delivery is long such that the child cannot endure it, then a cesarean section may be needed. Beyond these conditions, it is also important to evaluate the state of the pelvis, the size of the fetus, and the condition of the cervix. Generally, if vaginal delivery is possible for preterm births, it is still encouraged.
Does placenta previa cause preterm birth?
Placenta previa is likely to lead to premature birth. Why is that? Placenta previa refers to the condition where the placenta is positioned lower in the uterus, and the most common symptom is recurrent, painless bleeding during pregnancy. This is because the low-lying placenta often leads to frequent bleeding. If the bleeding is minimal, there is still hope to maintain the pregnancy, allowing the fetus to grow longer inside the uterus. However, in the event of heavy bleeding, if the baby remains in the uterus without delivery, a critical situation can arise due to blood loss, potentially leading to the disappearance of fetal heart activity. At this point, the pregnancy would need to be terminated, thus often resulting in premature birth.
Can oxytocin be used for premature birth?
Under normal circumstances, babies born between 28 and 37 weeks of gestation are referred to as premature infants. Persistent and regular abdominal pain, accompanied by dilation of the cervix, usually suggests preterm labor and a likely onset of labor, necessitating timely medical attention for appropriate examination and treatment. Normally, during the process of preterm labor, if there is insufficient uterine contraction or other abnormal conditions, it might be appropriate to use oxytocin to induce labor. If the mother has no other complications, vaginal delivery is still the primary method of delivery to reduce conditions such as fetal hypoxia in the uterus.
Is excessive amniotic fluid likely to cause premature birth?
Polyhydramnios is relatively common during pregnancy and can have a certain impact on the fetus. There are many reasons that can cause polyhydramnios, but regardless of the cause, polyhydramnios tends to lead to preterm birth. When there is an excessive amount of amniotic fluid, it puts significant pressure on the amniotic sac, which can easily lead to premature rupture of membranes. Premature rupture of membranes itself can stimulate the cervix, release inflammatory mediators, thereby causing contractions and symptoms of preterm labor. After the membranes rupture prematurely, infection within the uterine cavity is likely to occur, generally meaning that the possibility of keeping the pregnancy going for a long duration is unlikely. Therefore, polyhydramnios is associated with a higher risk of preterm labor. In clinical practice, if excessive amniotic fluid is detected during prenatal check-ups, it is advised to control the diet, engage in appropriate physical activities, or use other methods to keep the amniotic fluid level within the normal range.
Does premature birth affect intelligence?
Premature birth generally does not affect a baby's intellectual development, as the brain is mostly well-developed by the time of premature birth, and intelligence is not greatly affected. With appropriate nutrition post-birth, the intelligence of premature babies can generally recover to that of average children. However, if the baby experiences intrauterine hypoxia during premature birth, this can affect the brain cells and may even lead to cerebral palsy. Therefore, it is important to closely monitor the baby's diet and neurological responsiveness if premature birth occurs. If there are concerns, a hospital check-up can be conducted to promptly identify any issues with the child.