Preterm Labour
Prevention
Even if you have a healthy pregnancy, you may go into preterm labour. It is difficult to prevent preterm labour because it is usually not anticipated, and it is often due to causes that are not completely understood. However, following some general guidelines for a healthy pregnancy may help prevent preterm labour and will optimize your fetus's health and ability to thrive, whether at full term or preterm.
Being pregnant with twins, triplets, or more puts you at high risk for preterm labour and infant complications. If you are planning to use assisted reproductive technology or superovulation to conceive, talk to your doctor about reducing your risk of conceiving more than one baby. For more information, see the topics Fertility Problems and Multiple Pregnancy: Twins or More.
If contractions start
Contractions are a normal part of all pregnancies. Most contractions do not thin and open the cervix. Rather, they are simply a brief stimulation of the uterine muscle. This can happen when your fetus is moving a lot, when your bladder or bowel is full, or when you are dehydrated. These non-labour contractions are irregularly timed and uncomfortable rather than painful. You can wait to see how they progress before seeking care.
Preterm labour contractions tend to be regularly timed, becoming more frequent, painful, and prolonged (30 to 60 seconds) as they progress. You may also notice low back pain, thigh pain, or increased vaginal discharge or bleeding.
If you are less than 37 weeks pregnant and your uterus is contracting more than usual (about 4 or more in 20 minutes or about 8 or more within 1 hour) the following steps may stop your contractions:
- Drink 2 or 3 glasses of water or juice (not having enough liquids can cause contractions).
- Stop what you are doing, empty your bladder, and lie down on your left side for at least an hour.
If your symptoms get worse during the hour, call your doctor or registered midwife or go to the hospital.
If you are at risk for preterm labour
You may be able to help prevent preterm labour if you are at risk (see the What Increases Your Risk section of this topic). Avoid activities that can start contractions.
- Avoid using drugs such as cocaine and methamphetamines.
- Don't smoke.
- Eat a healthy diet that is low in saturated fat. Use olive or canola oil in place of other fats or oils. Get lots of whole grains, low-fat dairy, fruits and vegetables.
Health Canada have issued the following advisory for pregnant women, women of child-bearing age, nursing mothers, and young children.
- Limit the intake of shark, swordfish, mackerel, tuna, escolar, marlin and orange roughy to 150g per month. Review new fish advisories at Health Canada at www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2002/2002_41_e.html
Ineffective preventive treatments
- Bed rest. Until the recent past, long-term bed rest (expectant management) was commonly used to prevent preterm labour during the last half of pregnancy. However, recent research suggests that strict bed rest for 3 days or more increases your risk of developing a blood clot in the legs or lungs (from 1 in 1,000 to 16 in 1,000).12 No studies have shown that bed rest is effective in delaying labour.13, 11
- Cervical cerclage.Cervical cerclage is the placement of stitches in the cervix to hold it closed. It is rarely done. Cerclage is meant to stop the cervix from opening early, which could lead to miscarriage or preterm birth. Cerclage has helped some high-risk pregnancies last longer, but it also has risks—it can cause infection or miscarriage. Studies suggest that cerclage makes twin pregnancies more likely to deliver early. Experts do not yet know when cerclage is more likely to work and when it isn't.14
- Home fetal monitoring. Research has shown that home monitoring is expensive and has no proven effect on delaying early birth.15, 11
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| Author: | Kathe Gallagher, MSW Carrie Henley | Last Updated: April 10, 2007 |
| Medical Review: | Joy Melnikow, MD, MPH - Family Medicine Anne C. Poinier, MD - Internal Medicine Gregory A L Davies, MD, FRCSC, FACOG - Maternal-Fetal Medicine William Gilbert, MD - Perinatology | |
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