Premature birth

Premature birth

A pregnancy lasts an average of 40 weeks. A duration of 37 to 42 weeks is considered a normal pregnancy period. Contractions that occur before week 37 are called 'early'. Early labor increases the risk of premature birth. The baby can then be insufficiently prepared for the world and needs extra medical care. The treatment of preterm labor is aimed at postponing the time of delivery in the hope that, when baby arrives, he will be more prepared for the world.

What is preterm labor?
Early contractions feel no different from contractions around the due date. Contractions are often painful and occur regularly. As a result of contractions, loss of blood, mucus and / or amniotic fluid can occur.

  • In the Netherlands, 7-8% of all babies are born prematurely. Often the cause of premature labor and preterm birth is unknown.
  • The chance of an early delivery is higher if you have already had a premature birth.
  • An operation in which the cervix is ​​shortened increases the chance of an early delivery.
  • Other risk factors are:
    • multiple pregnancy;
    • too much amniotic fluid (polyhydramnion),
    • blood loss,
    • breaking the membranes prematurely,
    • weak cervix (cervical insufficiency) or
    • other illness of the expectant mother.

Treatment of a dangerous premature birth
The treatment of a threatening preterm birth depends on the duration of the pregnancy, your condition and the condition of your child. The degree of access is also important for the manner of treatment.

Bed rest
Bed rest and treatment of possible (bladder) inflammation with antibiotics often reduce the severity of contractions.

Diseases inhibiting medications
Your doctor may decide to give you painkillers when you are between 25 and 33 weeks pregnant.

Corticosteroids (adrenal cortex hormone)
In order to promote the maturation of your child's lungs, you get so-called corticosteroids (adrenal cortex hormone) in combination with the contraction-inhibiting medicines. The doctor prescribes these in two goes. The corticosreroids are given by injection. You will receive the second dose 24 hours after the first dose. When the corticosteroids are acted on (after 72 hours), contractions are generally phased out.

What can you do yourself?
Get as much bed rest as possible. If you feel that the contractions are changing, becoming more frequent and / or more painful, or if your child moves less than what you were used to, then it is important that you report this to the nurse.

If the delivery does not continue
When the contractions activity decreases or even stops, bed rest is no longer necessary and you can gradually walk around again. If this goes well and the contraction activity does not increase again, you can go home again after a few days. The advice is to get as much rest at home as possible. Only when it appears that there is no contractions activity can you pick up your daily activities again. Sex should be fine, as should be the return to work. Always consult your GP or midwife.

If the delivery continues
The birth of children younger than 32 weeks of gestation usually takes place in a hospital with a neonatal intensive care unit (NICU). From 32 weeks onwards it becomes steadily less risky. A premature baby can usually be born in the natural way. Because a premature baby has fewer reserves than a full-term baby, the hospital monitors the heartbeat of your child during delivery by means of a CTG. Usually a pediatrician is present during the birth. Depending on the duration of pregnancy and the condition of your child, the pediatrician will take your child to the baby room for the initial childcare after birth. If your child has been admitted to the NICU, you can stay in the maternity ward for the first six days after delivery. If it is medically justified, you can then take them home. Children born prematurely remain in the NICU for longer.

Source: AMC Amsterdam

 

 

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