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Preterm labour and birth

Partus praematurus · Předčasný porod

female only

What it is

Birth before 37 weeks — one baby in ten, and the leading cause of death in children under five.

Symptoms & signs

  • Regular tightenings before 37 weeks
  • low back ache or pelvic pressure
  • a gush or trickle of fluid (waters breaking)
  • bleeding or a 'show'
  • period-like cramps

🚩 Get help if…

  • call 112 / 911 now Regular contractions or period-like pains before 37 weeks
  • call 112 / 911 now Waters breaking or a gush of fluid before 37 weeks
  • call 112 / 911 now Bleeding from the vagina in pregnancy
  • see a doctor soon Pressure low in the pelvis or new backache before 37 weeks

Where it strikes

Medical treatment

  • Fetal fibronectin test and cervical length scan
  • steroids for the baby's lungs
  • magnesium sulphate before 30 weeks to protect the brain
  • tocolytics (nifedipine, atosiban) to delay birth 48 hours
  • antibiotics when the waters break early
  • progesterone or cerclage for a short cervix

Natural & lifestyle

  • Stop smoking
  • treat gum disease and urinary infections
  • space pregnancies at least 18 months apart

Emerging & experimental

  • Cervical pessary
  • treatments based on the vaginal microbiome
  • blood RNA tests to predict preterm birth

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Omega-3 (DHA) — Cochrane review: fewer births before 34 weeks where intake is low trials support
  • Bed rest — tested: no fewer preterm births, more clots not confirmed in trials
  • Acupuncture and herbal relaxants — untested for this anecdotal / traditional

ICD codes