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Premature Labor: Treatment, Procedure, Cost and Side Effects

What is the treatment?

Premature or preterm labour arises when a pregnant woman's body starts preparing for delivery way before the due date. Preterm labor can, in most cases , lead to an early birth if not controlled with the help of medical intervention. Typically, preterm labour starts three weeks before a woman's due date. Fortuntely, the delivery of the child can be delayed by adopting treatment methids for preterm labor. Only two types of methods are commonly used. One of them is a surgical procedure known as cervical cerclage and the other is the administration of certain medications in the form of injections or IV fluids. In case these treatment options fail to work, the doctor will suggest giving birth to the baby, which can be done vaginally or through a Cesaerean section , depending on the condition of the mother. Although it's popular belief that bed rest can help in controlling the symptoms of preterm labor, it really cannot and most doctors advise against it due to the potential risks it comes with.

How is the treatment done?

If the symptoms of preterm labour are mild, doctors will recommend the use of medications first. Three different types of medications are generally used and these are corticosteroids, magnesium sulfate and tocolytes. Corticosteroids are given when the woman is between 24 to 34 weeks pregnant and is administered via an injection. These help in slowing down the lung development of the baby. Magnesium sulphate is offered as treatment when ther's high risk of delivering the baby betweenb 24 and 32 weeks of gestation. It is administered intravenously. Lastly, tocolytes are given for short-term relief and help in delaying the delivery for up to two days. These are administered intravenously too. It should be mentioned here that each of these methods are carried out in a hospital. Apart from drugs, a surgery known as cervical cerclage is performed to halt delivery. This surgery can be performed either with the help of local or general anesthesia. Generally, the operation is carried out through the vagina. In this procedure, a speculum is inserted into the woman's vagina so that the vaginal walls can be spread apart for the surgery. To close the cervix in order to stop preterm labour symptoms, the surgeon may either stitch the outer part of the cervix or tie a tape around the cervix and then stitch it up. The surgeon may also make a tiny incision in the cervix and then tie a tape there to keep it closed.

Who is eligible for the treatment? (When is the treatment done?)

Pregnant women who are suffering from the symptoms of preterm labour are eligible for these treatment methods. They will have to be at least 24 weeks pregnant for the medications to work. Women who are less than 24 weeks are pregnant are eligible for the surgery.

Who is not eligible for the treatment?

Pregnant women who are suffering from complications are not eligible for any of these treatment methods. Moreover, pregnant women who are beyond 24 weeks pregnant are not the right candidates for surgery. Also women who are a couple of weeks before their due date may not be eligible for either surgery or medications.

Are there any side effects?

Side effects are a common occurrence in the use of medications to curb the symptoms of preterm labour. These side effects include nausea, dry mouth, headache, blurry vision, flushing, weakness, heartburn, veritgo, palpitations, nervousness, fever and feeling warm. Cervical cerclage has side effects too, which are contractions, cramping, vaginal bleeding, low back or abdominal pain, fever, nausea, foul odored vaginal discharge and more.

What are the post-treatment guidelines?

For medicines used to treat preterm labour, post-treatment guidelines include following a healthy diet, resting and immediately reporting any side effects that take place to the doctor. As for surgery, women may have to stay in the hospital overnight or for at least a couple of hours. Once discharged, they will have to routinely have the medicines prescribed and take bed rest for at least 2-3 days after the procedure. Abstinence from sex is also important. The doctor will inform the woman when she can resume normal activities.

How long does it take to recover?

The recovery time of cervical cerclage is not fixed and is entirely dependent on the way in which the procedure was carried out. As far as the medications, the side effects may take a couple of days to wear off so that the woman can recover.

What is the price of the treatment in India?

Cercival cerclafe is carried out in most hospitals in India and the cost of it ranges from Rs 10,000 to Rs 13,000. The medications used to treat preterm labour cost between Rs 200 to Rs 4870.

Are the results of the treatment permanent?

The results of each of these treatment methods cannot be defined as permanent per se. Their success depends on if the pregnancy lasts up to or at least close to the full term.

What are the alternatives to the treatment?

Bed rest is generally recommended as the best alternative to medical intervention for preterm labor. However, most medical experts do not advocate it now due to potential side effects.

Safety: Medium Effectiveness: High Timeliness: High Relative Risk: Medium Side Effects: Medium Time For Recovery: Low Price Range: Rs. 200 - Rs. 13,000

Popular Health Tips

Pre-term Labour - Factors That Can Increase Your Risk!

MS - Obstetrics & Gynaecology, Fellowship in Fetal Medicine
Gynaecologist, Amritsar
Pre-term Labour - Factors That Can Increase Your Risk!

Pre-term labour, also known as premature labour, is when the body starts getting ready for pregnancy earlier than it is supposed to. The labour starts more than three weeks before the due date is. It can lead to an early birth. However, nowadays, the doctors can do a lot to delay the birth and stop a premature birth from happening.

Here are a few things that can increase your risk of a premature labour:

  1. Smoking
  2. Being over or underweight
  3. Bad prenatal care
  4. Alcohol abuse or using drugs while pregnant
  5. Having bad health conditions like hypertension, diabetes
  6. Being pregnant with twins or multiple babies

The symptoms of a premature labour include:

  1. A backache, usually in the lower back.
  2. Contractions with ten-minute intervals
  3. Cramping in the lower abdomen like during periods
  4. Leaking of fluid from the vagina
  5. Feeling nauseous, diarrhoea and flu-like symptoms
  6. Increased vaginal discharge
  7. Extreme vaginal bleeding

There are a few ways with which you can check or make sure whether you will be having an early labour or not. These are:

  1. Put your fingers on your abdomen
  2. If you feel that your uterus is tightening and relaxing and then tightening again, it is likely that you might be having contractions. You should time your contractions. Write the timings down when each contraction starts.
  3. Stand up on your feet and change your positions. Try to relax and stop the contractions.
  4. Drink two to three glasses of water
  5. Call your doctor immediately if you continue having contractions every ten minutes.

Sometimes women have a harmless false labour. It is called the Braxton hicks contractions. However, these are not a part of the labour. In case you have been diagnosed with pre-term labour, you will need treatment. These usually include:

  1. IV fluids
  2. Medicines to stop the labour and relax the uterus
  3. Antibiotics
  4. Medicines to speed up the growth of the baby’s lungs
  5. Being admitted to the hospital

In case you are unable to stop your labour, the doctor will get ready to deliver the baby. The baby is then taken care of, outside in incubators and then released once it is fully grown and healthy. If a baby is premature and is born early, most of them do well as they keep growing old. However, they do have a higher risk of problems. These might include autism, cerebral palsy, lung problems, vision and hearing loss, and intellectual disabilities. The earlier a child is born; it is more likely that they will face health problems. Therefore, it is very important that the mother, as well as the child, is taken very good care of before and after a pre-term labour or birth. In case you have a concern or query you can always consult an expert & get answers to your questions!

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9 Causes Behind Premature Labour!

MBBS, MS - Obstetrics & Gynaecology, DNB - Obstetrics & Gynecology - Obstetrics & Gynecology
Gynaecologist, Ghaziabad
9 Causes Behind Premature Labour!

The usage of “9 months” with pregnancy is almost universal. However, it is not always that all women go through the entire 9 months with the baby. Most often, delivery happens during the 37th to 40th weeks. This allows for the complete growth of the baby within the mother’s womb. When delivery happens before the 37th week, it is known as preterm delivery or premature labour. These babies may not be completely formed and may have temporary or long-term difficulties after birth.

There are many reasons which can induce premature labour, and while some are preventable, some may be inevitable.

  1. Smoking: One of the first things to do when planning a pregnancy or as soon as you realise you are pregnant is to quit smoking. It is way too damaging for the mother and the baby within.
  2. Alcohol consumption or street drug usage: These again can cause not just premature labour but also developmental abnormalities.
  3. Multiple pregnancy: Women pregnant with twins or multiples often have premature labour.
  4. Health problems: Medical conditions like hypertension, diabetes, infections, etc.
  5. Abnormalities: Developmental abnormalities in the newborn like Down’s syndrome, chromosomal abnormalities, etc.
  6. Weight: Being either obese or underweight can cause premature labour.
  7. Infection: Vaginal or urinary or fever and even dental infection.
  8. Prenatal care: While preparing for pregnancy or as soon as you confirm it, ensure you put yourself in the hands of a good gynaecologist. This will ensure you (and your baby) get the required care.
  9. Less gap: Reduced gap between subsequent pregnancies can also induce premature labour.

Warning signs of premature labour

In some women, the doctor might be able to predict the chances of a premature labour and give enough suggestions to look out for warning signs. This will help the woman to be mentally prepared when it is time.
A low backache, which is constant and does not go with usual relief measures.

  1. Frequent pelvic contractions (about every 10 minutes)
  2. Vaginal leaking (fluid or bleeding)
  3. General ill-feeling with symptoms of nausea, cramps, and vomiting/diarrhoea.
  4. Inability to hold down fluids for a full day
  5. Abdominal cramps, similar to a period
  6. Pelvic pressure, a feeling of the baby descending down

What to do? 

As mentioned earlier, if your doctor had warned you of the chances of a preterm labour, watch out for them after 35 weeks.

  • With any of the above symptom, do not indulge in any activity and rest on the left side for a while.
  • Drink about 2 to 3 glasses of juice or plain water.
  • If the symptoms get better, continue to rest for the day.
  • If they do not, call the doctor. Usually, the doctor will ask you to come to the clinic.
  • In some cases, the baby might be delivered and require neonatal care for some days (to weeks) depending on development and symptoms.

If your waters break, or you start having contractions before 37 weeks of pregnancy, contact your doctor or hospital immediately. Even if it's the middle of the night, don't wait until morning, get on the phone straight away! 

You will almost certainly be asked to go to the hospital immediately. Don't drive yourself. If you have nobody to give you a lift, call an ambulance. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

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Popular Questions & Answers

She is suffering for irregular periods before labour can Periods come normal after labour.

Bachelor of Ayurveda, Medicine and Surgery (BAMS), Certificate In Food And Nutrition (CFN).
Ayurveda, Ernakulam
Hai lybrate-user, for some females period get regular after delivery but some do continue to have irregular periods. Individual differences are there.
3 people found this helpful

I m 31years old and 23 weeks pregnant. I m started taking susten tablet from 6 the week till now. Do I need to continue taking tablet. How long I should take. In my first trimester scan cervix was 3.7 cms In my second trimester scan cervix was 3.3 cms Why size of cervix decreased. Doctor advised me not to do any work told me to take complete bed rest to avoid premature labor. What should I do now. Pls help.

DGO, MD, MRCOG, CCST, Accredation in Colposcopy
Gynaecologist, Kolkata
There can be observer variation in measuring length of cervix. As long as it is more than 2.5 cm there is nothing to worry. Also if you have not gone into preterm labour before chances are very low unless your pregnancy this time has developed any new complications. You can continue to take susten tablet as advised but there is no evidence to show that bed rest in pregnancy prevents preterm labour.
13 people found this helpful

Hello doctor I am 9 month 3 days pregnant I want to know the symptoms of labor how would I know that I am going into labor?

General Physician, Delhi
You may have varied symptoms like pain in abdomen or lower back, leaking from vagina, bleeding, or also some times pressure lower down. You should also keep a check on the movements of the baby.
1 person found this helpful

What are the symptoms and side effects of early labor delivery? Why early labor causes?

Sexologist, Noida
These babies are known as preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes or the leaking of fluid from the vagina. These risks are greater the earlier a baby is born. The cause of preterm birth is often not known.
1 person found this helpful

Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?
Having issues? Consult a doctor for medical advice