Premature Delivery: Symptoms, Causes, Risk Factors, Complications, Diagnosis and Treatment

In most cases, a pregnancy lasts about 40 weeks.

However, certain complications can arise that can cause early manifestation of signs of labor and possibly premature delivery of a child.


Preterm labor occurs when a woman begins to experience contractions and signs of labor after the 20th week of pregnancy and more than three weeks before full-term delivery.

Preterm labor is when the uterus regularly tightens and the cervix begins to thin and open.

This allows the baby (fetus) to enter the birth canal.


Preterm labor or premature birth is generally an unplanned event.

Depending on the causes of the birth and how premature the baby is, it can also be an emergency.

In many cases, premature birth cannot be avoided.

Preterm birth can have many causes, including problems with the fetus, the mother, or both.

However, about fifty percent of the time, the causes of premature birth are unknown.

Preterm birth most often appears as a result of a premature rupture of the fetal membranes that initiates labor.

There are a number of causes and risk factors that lead to preterm labor, such as:

  • Gestational hypertension.
  • History of placental abruption or placenta previa.
  • Blood clotting disorders.
  • Eclampsia o preeclampsia.
  • A short umbilical cord.
  • A cesarean section in the previous pregnancy.
  • Maternal infection.
  • Bleeding early in pregnancy.
  • Acute trauma, such as a car accident, blow to the abdomen.
  • Excessive use of alcohol, tobacco, or drug use (such as cocaine and methamphetamine) during pregnancy.
  • Multiple births.
  • Advanced maternal age.
  • Severe emotional or physical stress .
  • Cervical problems.
  • Abnormal shape of the uterus.
  • A woman who has had numerous pregnancies.
  • Uterine abnormalities.
  • The presence of fibroids.
  • Certain birth defects.
  • Hormonal changes.
  • Stretching of the uterus. This could be from more than one fetus, a large fetus, or too much amniotic fluid.
  • Age younger than 20 years or older than 35 years.
  • Long-term illness such as heart disease or kidney disease.
  • The cervix cannot remain closed.
  • Have a preterm labor in the past.
  • Be African American.
  • Placenta that detaches from the uterus early or in an abnormal position.
  • Early rupture of the sac around the fetus (premature rupture of membranes).
  • Problems with fetal growth

Risk factors for preterm birth

There are a number of factors that can put a pregnant woman at higher risk for preterm labor.

If you had a previous preterm birth, your chances of having another preterm birth increase two and a half times.

That rate jumps to 10 times if your previous preterm labor occurred before the 28th week of pregnancy.

It is important that you and your healthcare provider take this into account so that they can provide you with the proper care throughout your pregnancy.

Another major risk factor for preterm labor is being pregnant with twins or multiples.

The rate of twins and multiples has increased in recent years, mainly due to the use of fertility drugs and other assisted reproductive techniques.

About half of all twins are born at 36 weeks or less.

Half of the triplets deliver before 32 weeks.

Many mothers of twins and multiples go into premature labor spontaneously.

Others may need preterm labor due to complications during pregnancy.

An important risk factor is infection. Some types of infection that can cause premature birth are:

  • Untreated UTIs: Double the risk of preterm birth. UTIs are checked at every doctor visit and can be treated with antibiotics.
  • Bacterial Vaginosis: They also double the risk of preterm labor. The main symptom of vaginosis is a light or heavy vaginal discharge with a slight “fishy” odor. Vaginosis is treated with antibiotics.

There are several other risk factors for preterm labor.

Some of these risks, such as anemia, slow maternal weight gain, stressful work habits, smoking, drinking alcohol, and using drugs such as cocaine, can be corrected during pregnancy.

Other risk factors for preterm birth include age younger than 17 or older than 40, previous multiple miscarriages, and low pre-pregnancy weight.

Knowing these risks can help determine if you will need special care to prevent preterm labor.


Many women who experience preterm labor receive the appropriate treatment necessary to enable them to deliver near or full term.

Sometimes, however, preterm labor cannot be stopped or, in some cases, a complication may require that the child be delivered immediately.

If a child is born prematurely, this could cause a number of health problems.

In general, the risks associated with preterm labor depend on how early a child is born (that is, babies born before 32 weeks are more vulnerable to complications).

Diagnosis of preterm labor

Signs and symptoms will be monitored and recorded by a medical professional early on to determine the extent of the underlying problem.

If you experience contractions that are regular and painful, and your cervix has started to soften, thin, and dilate before 37 weeks of pregnancy, you are likely experiencing preterm labor.

In general, the following are the tests and procedures necessary to diagnose a case of preterm labor:

Pelvic exam: A medical professional will examine the firmness or tenderness of the uterus, as well as the size and position of the baby in the uterus. He or she will also take a look at your cervix to determine if it has started to dilate.

Ultrasound: This procedure is useful for measuring the length of your cervix and for examining the size, weight, and position of the baby in the uterus.

The doctor should repeat this procedure, to measure the progress of the pregnancy in case preterm labor becomes a concern.

Uterine and fetal monitoring: The obstetrician may also use a uterine and fetal monitor to monitor the status of contractions and the baby’s heart rate.

Amniocentesis: This is a procedure in which a syringe is inserted into the uterus to remove a sample of the amniotic fluid that surrounds and protects a growing fetus.

This procedure is usually done after the 15th week of pregnancy, which is able to determine your child’s lung maturity.

This technique can also detect if you have an amniotic fluid infection that could be causing your preterm labor.

Testing for fetal fibronectin: This is a protein found between the amniotic membrane and the uterine lining. A swab of cervical or vaginal fluid is examined and if present, it may be a sign of preterm labor.

Treatment for preterm labor

If the 34th week of pregnancy has not yet been reached when labor begins, your doctor may treat you with medications, including:

  • Tocolytic medicines: These help slow or stop contractions. They can be given by injection or intravenously. Nifedipine, a drug used in these cases.
  • Steroid injections: and other medicines to help your baby’s lungs strengthen, grow, and mature. Corticosteroids help prepare the baby for life outside the womb. The lungs of premature babies may not be able to function on their own.
  • Antibiotics – to help clear any infection that may be causing preterm labor.
  • Cervical cerclage: This procedure is used to attach the cervix. It can be done when the cervix is ​​weak and cannot stay closed.
  • Delivery: The doctor will deliver the baby if treatments do not stop preterm labor or if the patient or baby is in danger. You may need a cesarean section.

Some doctors may also prescribe bed rest, especially if you cannot take nifedipine, in the hope that the pregnancy will continue for as long as possible to give your baby more time to fully develop.

You may also require hospitalization to be able to monitor the pregnancy and be ready to care for the baby immediately if you need special medical care after the birth.

If you have contractions at any time during your pregnancy or have other worrisome symptoms, you should call your doctor.

If preterm labor is diagnosed early in the process, it may be easier to delay or even stop the pregnancy for a time.

Health problems in premature babies

The earlier babies are born, the more problems they will have and the more severe the problems will be.

Some premature babies do very well and do not require much medical intervention.

However, others are very sick and need a lot of help.

Complications of preterm birth can be short-term and go away once they develop and get stronger, and others can be long-term or permanent.

It is common for premature babies to be a little behind their peers in meeting developmental milestones such as crawling, walking and talking, but most of them will recover in the first few years.

Some of the problems that premature babies can have are:

  • Lack of surfactant in the lungs (a substance that helps the lungs stay inflated).
  • Respiratory distress syndrome, a condition caused by immature lungs that makes it difficult to breathe.
  • Difficulty controlling body temperature.
  • Problems eating and digesting food.
  • Infections
  • Jaundice .
  • Bleeding in the brain .
  • Hearing and vision problems.
  • Difficulty making sounds, crying, or communicating.
  • Cerebral palsy and other neurological disorders.
  • Developmental delays.
  • Low birth weight.
  • Underdeveloped organs.