Pre-term Labour Overview

Definition of Pre-term Labour

• Pre-term Labour (PTL) occurs when uterine contractions and cervical changes happen between 24 and 37 weeks of gestation.
• Can be spontaneous or triggered by premature rupture of membranes or iatrogenic factors related to maternal or fetal causes.
• PTL significantly increases the risk of neonatal morbidity and mortality.

Causes of Pre-term Labour

• Infection: Includes chorioamnionitis and sub-clinical chorioamnionitis.
• Maternal Factors: Conditions such as pyrexia (fever) can trigger PTL.
• Uterine Factors: Cervical insufficiency is a primary uterine factor.
• Fetal Factors: Carrying multiples (twins, triplets) or conditions like polyhydramnios contributes to the risk.
• Placental Issues: Problems such as placenta previa or placental abruption are associated with increased PTL risk.

Impacts of Pre-term Labour on Perinatal Outcomes & Long-term Health

• Increased Perinatal Death: Higher likelihood of death shortly after birth.
• Increased Morbidity:
  • Short-term complications: Respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, hypothermia, hypoglycemia, jaundice, and various infections.
  • Long-term complications: Risks for developing cerebral palsy, vision loss, and hearing loss.

Management in Antenatal Care (ANC)

• History Taking: Identifying important risk factors through history is crucial.
  • Previous occurrences of PTL.
  • History of second-trimester miscarriage.
  • Lifestyle factors such as smoking.
  • Socioeconomic status indicators that may affect health.
  • Consideration of maternal BMI levels.