Naturally induce labor at 37 weeks

7 Natural Ways to Induce Labor

Anecdotal evidence suggests that exercise, sex, and eating certain foods may help move labor along. But it’s best to talk with a healthcare professional before attempting to induce labor.

Your due date is an educated guess for when your baby might make its arrival.

While many women deliver perfectly healthy babies 2 weeks before or after this presumed due date, it’s recommended that women wait until at least 39 weeks for delivery.

It’s best to let mother nature decide when your baby comes.

In a 2011 study, 201 women who had recently delivered babies were surveyed about inducing labor at home. Of these women, 50 percent had tried a natural method of getting labor started.

If you’re 40 weeks in, here are seven natural ways to get things moving along.

Most of these methods are anecdotal and don’t have solid evidence that they work, so you should always talk to your healthcare provider before attempting any of these methods.

Your midwife or doctor may not be able to confirm that they work, but they can let you know if it’s safe to try with your pregnancy.

Exercise can be anything that gets the heart rate up, such as a long walk. Even if this method doesn’t work, it’s a great way to relieve stress and keep your body strong for the task ahead.

Theoretically, there are multiple reasons why having sex could induce labor.

For example, sexual activity, especially having an orgasm, can release oxytocin, which may help jumpstart uterine contractions.

Also, for pregnant people who have sex with men, there are prostaglandin hormones in semen that might help ripen the cervix.

Having sex is safe during the final weeks of pregnancy, but you shouldn’t have sex after your water has broken. Doing so can increase your risk for infection.

Stimulating your nipples can cause your uterus to contract and may bring about labor.

Nipple stimulations stimulate oxytocin production. Oxytocin is the hormone that causes the uterus to contract and the breast to eject milk.

In fact, if you choose to breastfeed your baby right after delivery, this same stimulation is what will help your uterus shrink back to its original size.

You or your partner may manually stimulate your nipples, or you can try using a breast pump.

Solidresearch shows that breast stimulation can be an effective way to:

induce and augment labor
avoid a medical induction
reduce rates of postpartum hemorrhage

Acupuncture has been used for thousands of years. The exact way that acupuncture works is unclear.

In Chinese Medicine, it’s believed that it balances the chi or vital energy within the body. It might also stimulate changes in hormones or in the nervous system.

Acupuncture should be administered only by a licensed acupuncturist.

In a 2013 randomized trial in Denmark, more than 400 women were given acupuncture, membrane stripping, or both procedures before labor.

Study results showed that acupuncture didn’t decrease the need for induction, but sweeping membranes did.

According to research, the main benefit of acupuncture is increased cervical ripening.

Some practitioners believe that acupressure can help start labor. Prior to applying acupressure to yourself, make sure you get proper instruction from a trained acupressure professional.

If acupressure doesn’t get your labor going, it can still be an excellent way to alleviate pain and discomfort during labor.

Drinking a little bit, like only 1–2 ounces (29.57–59.14 mL) of castor oil stimulates prostaglandin release, which can help ripen the cervix and get labor started.

It’s recommended that this be done under the supervision of a midwife or doctor. People should be careful not to drink too much.

Someresearch shows that eating dates in the final weeks of pregnancy

increases cervical ripening and cervical dilation at the start of labor
decreases the need for Pitocin use during labor

Most pregnant people at 40 weeks are likely ready to have their babies out of their bellies as soon as possible and in their arms.

However, there are plenty of perks to waiting until your body naturally decides to go into labor — including recovery.

Women who weren’t induced typically recover more quickly than those who were. More time in the womb can mean both you and your new baby get to go home from the hospital sooner.

Infants who are born after a full-term pregnancy also experience other benefits. More time in the womb typically means:

more time to build muscle and strength
reduced risk of low blood sugar, infection, and jaundice
improved breathing as infants born even as little as two weeks early can experience twice the number of complications
better feeding once born
increased brain development, with the brain growing a third of its size between weeks 35 and 40

Let your body do the work for a few more days and take the time to get as much rest as you possibly can.

We know, that’s easier said than done when you’re 9 months pregnant. You and your baby will need all your energy soon enough!

Before trying anything that might induce labor, speak with your healthcare provider to go over any risks or possible complications.

Though some of these methods are popular folklore among pregnant women, little scientific evidence supports their efficacy.

In most cases, it’s best to let baby set their own birth date, even if it means waiting another week or two.

Inducing Labor Naturally: What Works And What Doesn't

[Note of caution: Banner Health does not endorse anyone trying to self-induce labor before 37 weeks, as the baby’s brain is still developing]

You’re tired, your ankles are swollen, and you feel like your stomach may pop. If you are close to your due date – or a few days past – you may find yourself searching the internet for sure-fire ways to self-induce labor at home. While there are plenty of old wives’ tales and “natural” remedies that supposedly help nudge labor along, most don’t work and even worse, they can cause some undesired side effects.

“Unfortunately, most of the potential techniques don’t work and can be downright unpleasant on the digestive tract, but a few are worth a try,” said Linda Nelson, a certified nurse-midwife at Banner Health Clinic in Loveland, Colorado. “Before you try any of these though, make sure you get the OK from your midwife or physician.”

Below, Nelson weighs in on which methods are safe to try, and which aren’t worth the negative side effects.

Give It A Go … With Your Doctor’s OK

Sex

While it may the very last thing you want to do at this point in your pregnancy, sexual intercourse isn’t harmful unless your doctor has ordered pelvic rest for placenta or vasa previa. Although there is no proof it will start your labor, sex can help prime your cervix and make it more favorable for labor.

“When your partner ejaculates during sex, his sperm releases prostaglandins which can stimulate the cervix,” Nelson said. “So, it’s worth a try, if you are up for it!”

Walking

Unless otherwise advised by your doctor, it’s important to stay active during pregnancy—for you and the baby’s health. Although staying fit during pregnancy won’t induce labor, some studies have shown spending time upright can shorten labor.

“By walking and doing regular upright exercises, particularly toward the end of your third trimester, gravity can help your baby get in a good position for birth and it may help bring on contractions but not necessarily help labor progress,” Nelson said.

Nipple stimulation

Nipple stimulation, which involves gently rubbing a nipple between your fingers, using a breast pump or a combination of both, can help release oxytocin. But Nelson cautions doing this unsupervised.

“The reaction to nipple stimulation is very unpredictable, so if done incorrectly, you could give yourself too many contractions,” Nelson said. “If you want to try this method, make sure you only do it under your provider’s supervision.”

Dates (the fruit)

New studies have shown that six dates a day starting at 36 weeks can help soften the cervix, reduce the need for medical induction and help promote a shorter labor.

Evening Primrose Oil (EPO)

Used after 37 weeks, EPO does have substances that your body changes into prostaglandins, which can help soften your cervix and help it thin, but there are no formal studies to show its impact on labor.

Membrane stripping

If your cervix is favorable, your doctor or midwife, using a gloved finger, can separate the amniotic sac from the area around the cervix. This action releases prostaglandins, which can potentially help the body to go into labor.

“This process can be quite painful and isn’t without risks, such as rupturing the amniotic sac, cramping, bleeding and risk of infection,” Nelson said. “But for some women, it can reduce the chances of needing a formal induction.”

Don’t Try These

Castor oil: Unless you want horrible diarrhea, forgo the oil. It can also cause uterine irritations and contractions, but not the kind that result in labor.

Spicy food: This has the same effects as castor oil and can give you horrible heartburn.

Pineapple: There’s no harm in enjoying some throughout pregnancy, but this won’t help induce labor. Overindulging could produce diarrhea and heartburn.

The Takeaway

Most are safe to give a go but be sure to check with your midwife or OB/GYN beforehand to ensure the safest path to take.

“Truly the safest ‘natural’ approach is time,” Nelson said. “Only 2% of women remain pregnant more than one to two weeks past their due date. Just be patient and enjoy your last few days of your pregnancy.”

For any questions or concerns, contact your provider or call the Banner Nurse Now line 24 hours a day, seven days a week at 844-259-9494. If you still haven’t taken a CPR or childbirth class, you can also schedule at bannerhealth.com/calendar.

In preparation for your little one's arrival, check out these other articles about the ten must haves when preparing for a baby, natural childbirth, supporting your wife/partner during a C-section and breast milk or formula - how to choose. Visit the parenting section of our Banner Health blog for other helpful advice and tips for raising a happy and healthy child.

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37th week of pregnancy, baby weight, photo, pregnancy calendar | Mamovediya

At the 37th week of pregnancy, your body may signal the approach of childbirth, and if the pregnancy is not the first, then it is likely that the baby may want to appear in this world this week. Be attentive to how you feel, but remember that labor can begin now or in 4-5 weeks. The main thing is to stay calm and happy, and let the baby choose his own birthday. nine0003

What's going on?

Baby is 35 weeks old. Its weight is about 2.95 kg and is growing rapidly. Child is growing by 1 cm weekly and is now 47 cm from crown to legs of and 35 cm from head to tailbone.

The baby starts giving birth, it is he who knows when it is time for him to show himself to this world and, above all, to his mother. Be ready for the desired meeting and at the same time do not rush the baby, let everything happen in a timely manner. nine0003

But be that as it may, the baby does not waste time - he continues to gain weight and grow. The child continues to store fat (approximately 30 g per day). Breast milk comes gradually after childbirth, so it is vital for the baby to stock up on fatty tissues in order to have the strength to wait and get it.

The nervous system undergoes a gradual change - the process of creating a protective film around the nerves begins. nine0003

Quite a lot of cheese-like grease remains, and from lanugo, the fluff that covers the child's body gradually disappears.

Improves the respiratory system. Baby actively trains the lungs - performs respiratory movements, inhaling and exhaling amniotic fluid . The hormone cortisone, which promotes the maturation of the lungs, is already being produced in such quantities that a newborn baby can breathe on his own even this week! Surfactant is also actively produced in the lungs. nine0003

The cartilage of the ears and nose becomes somewhat harder

In the last weeks of its intrauterine life, the baby spends 30-60% of sleep in the period of REM sleep, which is characterized by an increase in blood pressure, rapid heartbeat, a significant decrease in muscle tone . The rest of the time is a period of slow sleep, which is accompanied by calming and relaxing the muscles. It is impossible to determine which of the periods is more necessary, they are both vital for the development of the baby. nine0003

What does it feel like?

37 weeks gestation is the average term for carrying twins, and women who have given birth earlier are more likely to go into labor this week. If this will be the first birth, most likely the baby will live in your tummy for a few more weeks.

In all 37 weeks of pregnancy you gained approximately 13.5 kg . Your tummy is already so big, but how could it be otherwise when a fully formed baby hid there. From the pubic symphysis, the top of the uterus rises by 37 cm, and from the navel by 16-17 cm.

“Term pregnancy” – this is exactly the definition that every expectant mother wants to hear before childbirth

The 37th week brings you very close to it, and therefore no one will stop childbirth this week. Remind your husband that the car must be in full combat readiness: the wheels are inflated, the tank is filled, and the engine is working. The phone should also always be with you: charged and with money in the account!

Suddenly you want to re-paste the wallpaper, rearrange the furniture in the whole apartment or do a general cleaning? nine0021

And besides, do strengths and energies fill you from within? Do not be surprised - hormones contribute to all this - and you are guided by the so-called nesting instinct. And yet, you should not engage in a large-scale restructuring of the apartment, since there are risks of not having time to complete what you started. And physical activity can provoke the onset of labor, so do not rush the baby, leave him the right to choose his birthday.

Is it easier to breathe, is there less pressure on the internal organs? It's a harbinger of childbirth - the child descended into the lower pelvis . But along with relief in one, comes discomfort in the other. The baby presses on the nerves, muscles and ligaments, causing shooting pains in the legs and perineum. And the bladder also suffers - so the toilet is your best friend until the end of pregnancy. And do not forget that the baby continues to grow and gain weight, which means that the long-awaited relief is not for long - until the 40th week, the baby's legs will again reach your sternum.

But no matter how hard it is sometimes, there are many wonderful moments that make pregnancy the best event in the life of every woman... Leave them in your memory... just a little bit left...

Nutrition of the expectant mother!

The nutrition of an expectant mother remains an extremely important aspect of her life. Proper, healthy, nutritious nutrition should become the rule for you, because breastfeeding is ahead (you will continue to feed the baby with what you eat yourself, the way the food enters will just change - it will get to the baby with your milk), and then you you will set an example for the child (it is unlikely that the child will want to eat cereals and soups if everyone at home eats fried potatoes and chips). Therefore introduce family traditions of healthy food .

Risk factors for mother and child!

If you have certain risks, then most likely you are already in the maternity hospital under the supervision of a doctor or have clear instructions for your further actions in case of a deterioration in well-being and the like. If there are indications for a caesarean section, discuss all the nuances and details with your doctor again.

All kinds of acute respiratory infections, colds, and even more so the flu are now extremely undesirable

First of all, the disease will weaken your body and may complicate the course of childbirth. And secondly, there is a danger to the baby. So, your task number 1: to minimize the risks of infection:

during the period of exacerbation of the epidemiological situation, try to avoid crowded places - malls, shops, public transport, etc.;
Wash your hands more often than usual and make sure everyone in the household follows this rule;
If there is a patient in the house, it is better to isolate him as much as possible and ask him to leave the room only in a mask. The frequency of hand washing in this case increases three times. You should also wash the floor and ventilate the apartment. And if possible, it is best to temporarily move to relatives, or send the patient there. nine0078

Important!

The baby is already well settled down and preparing for his appearance in this world. Time flies very quickly and now the count goes on for weeks, and possibly days. In the last weeks of pregnancy, the doctor may suggest or recommend another ultrasound. Ultrasound will show the exact placement of the baby in the uterus, and the doctor will definitely check if the umbilical cord is wrapped around the baby's neck . These data are very important in order to properly organize the birth process. The doctor this week can already determine the predicted weight and length of the fetus with great accuracy. nine0003

If you have already taken courses on preparation for childbirth and future motherhood, it's time to remember breathing exercises - practice breathing correctly during labor, this will help reduce pain and will contribute to the rapid opening of the cervix

By the way, there is a theory that the opening of the cervix can still be facilitated through visualization. The cervix is a muscle, which means it should be relaxed. To do this, you should visualize the opening of the cervix: you need to imagine natural processes and associate them with the cervix. Imagine a rose blooming...

Or imagine how well the circles on the water move quickly and evenly during the rain . ..

Breathe correctly and imagine how the cervix opens like a rose, or diverges like circles on the water, wider and wider with each contraction , opening the way for the baby. Now train, and during contractions, be sure to refer to this practice, if you manage to relax the cervix, then its opening will be much faster and with minimal pain.

If for some reason you have not had and are not able to attend pregnancy courses, then find videos on the Internet. Here, for example, is a wonderful lecture on breathing during childbirth from an obstetrician-gynecologist, perinatal psychologist Kobasa A.D.:

Breathing during contractions: https://www.youtube.com/watch?v=puettCpCFO4
Breathing during contractions: https://www.youtube.com/watch?v=wahy4gELcho.
Natural birth course:

https://www.youtube.com/watch?v=2Rkaq9LRvYM&list=PLh2mNtsptFEMmytU1eu8jad0TZD1u8XaP.

Currently, there is a lot of useful information in the public domain, so choose those authors who present the material in an accessible and high-quality manner, and whose competence you do not doubt. And we wish you an easy birth and health. nine0003

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Skip to 38th week of pregnancy ⇒

Premature birth - Juno

Premature birth: article content

What is The birth of a baby weighing more than 0.5 kg from 22 to 37 weeks is considered early. According to statistics, 15 million babies are born prematurely around the world.

In our country, until 2012, babies were registered who were born at 28 weeks, and all those born earlier - a week later. The development of obstetrics made it possible to nurse critically premature babies and increased their survival statistics. nine0003

Who is at risk

Any pregnant woman can give birth prematurely. Some expectant mothers have a higher chance of preterm birth. The risk zone includes pregnant women:

under 17 and over 35;
have more than one fetus;
have structural features of the uterus or its cervix;
use harmful substances - drugs, alcohol, smoke;
have heavy physical activity; nine0078
have a history of preterm birth;
work in hazardous production;
are subjected to sexual, emotional abuse, stress, mental stress.

At risk are expectant mothers who are not registered during the gestation period or ignore ultrasound, screenings, laboratory tests.

The threat of early preterm birth is more common with diagnoses: diabetes mellitus, anemia, hypertension, genitourinary infections, hypothyroidism, problems with weight before conception (deficiency or obesity), thrombophilia, vaginal bleeding. There is also a risk when conceiving through IVF, with congenital malformations of the fetus. nine0003

If a woman has previously given birth to a child ahead of schedule, the chances of premature birth remain in subsequent pregnancies. The same applies to the weight of the crumbs: if the firstborn was born with a lack of body weight, then his brother or sister may be underweight.

Risk factors

Doctors point to a number of factors that take place long before the conception of a child. These include:

Gynecological diseases suffered in childhood or adolescence; nine0078
Early initiation of intimate life;
Hereditary factor;
Pathologies of previous pregnancy: preeclampsia, fetoplacental insufficiency, premature birth;
Excessive uterine distension in multiple pregnancies, polyhydramnios;
The threat of miscarriage in the early stages.

Another risk factor is surgery or trauma to the abdominal organs during the gestation period. nine0003

Risk of preterm birth at different terms

The birth of a child prematurely has many negative consequences for him. It depends on the trimester in which the pregnancy ended.

The most severe consequence is the death of the infant. With early preterm birth in the period of 22-24 weeks, the threat is the highest - up to 80% of babies die. This occurs against the background of intracranial hemorrhage of 3-4 degrees, cardiopulmonary insufficiency, intrauterine infection of the fetus. nine0003

Among those born in the period of 25 - 26 weeks, 40% of babies die, in 27 - 28 - about 20%, in 29 - 32 - no more than 10%, and in 33 - 34 - 2% of newborns are at risk.

Modern medicine is able to provide care for a premature baby and save his life. But no one can guarantee a full healthy life. Such a child can subsequently be given disappointing diagnoses: cerebral palsy, mental retardation, retinopathy of prematurity. He may suffer all his life from problems with the digestive and respiratory systems, impaired vision, hearing, delayed mental and physical development. Diagnosis implies disability. nine0003

For a woman in labor, preterm labor is usually not dangerous. Without concomitant pathologies, the mother's body does not care how long the child is born. There are only psychological problems: stress, fear and worries about the baby. It is better for a mother to tune in that her child, in case of severe prematurity, will be taken to the intensive care unit for nursing, so she will not see him immediately.

A newly minted mother needs rehabilitation. Therapy is prescribed, depending on the cause of the pathology: a complex of vitamins, antioxidants, hormones. nine0003

Why preterm birth is dangerous

Infants are immature: their body is covered with a large amount of cheese-like lubricant, there is a deficiency of subcutaneous fatty tissue, few hairs on the head and fluff on the body, cartilage on the ears and nose are soft, the nails do not go beyond the fingertips, the navel is located closer to the pubis.

Babies are underweight. Depending on the weight of the crumbs, 4 degrees of prematurity are distinguished: at the 1st degree, the baby weighs from 2500 to 2001 g, the 2nd - from 2000 to 1500 g, the 3rd - from 1500 to 1001 g, the 4th - 1000 g and below . nine0003

The development of the genital organs has not been completed: the testicles in boys are not lowered into the scrotum, and in girls the large labia do not cover the small and clitoris.

Children have immature lungs. They cannot breathe adequately - often they need help. The cry is weak. There are also problems with digestion. The body cannot absorb all the components from mother's milk.

Extrauterine life for children becomes a strong stress. It's hard to deal with him. They poorly resist infections, quickly lose heat, thermoregulation is impaired. They are subject to hemorrhages against the background of fragile vessels. Especially dangerous are hemorrhages in the cervical spinal cord and ventricles of the brain. nine0003

Among the complications of preterm birth are intracranial hemorrhages, asphyxia, intrauterine growth retardation.

Types of preterm birth

Several classifications have been adopted. Let's consider them.

By term: critically early - up to 28 weeks, significantly early - from 28 to 32 weeks, moderately early or late - from 32 to 37 weeks;
By the mechanism of attack: induced and spontaneous. Induced cause artificially for medical reasons. Occurs in 40% of cases. Spontaneous in 60% of cases begin with contractions, in 40% - with a rupture of the membranes; nine0078
By the nature of the course: spontaneous, with regular labor activity, without it and artificially provoked. In 80% of cases, preterm labor begins spontaneously. At the same time, the fetal bladder can be intact - and then the contractions are regular, growing. Or amniotic fluid may pour out, labor activity is chaotic. For medical reasons, early delivery can be artificially induced. For example, in case of danger to the life of the mother, intrauterine death of the fetus, or defects that are incompatible with life; nine0078
By symptoms: threatening, incipient and incipient. With threatening early premature birth, the lower abdomen and lower back hurt, the tone rises. Her neck remains unchanged, the external os is closed. When the process begins, pains appear in the lower abdomen. Regular contractions may begin. The neck is flattened or shortened. The main symptom of the onset of preterm labor is regular labor activity. The cervix opens by 2 - 3 cm, it happens quickly.

In 40% of women in labor, water breaks, 35% gave birth quickly and quickly. The active phase lasts less than when the baby appears on time. The contractions are monotonous, long and painful, the pauses between them are small.

Causes of preterm birth

Doctors indicate the main causes of the pathology:

Early activity of the fetal endocrine system;
Infections and inflammatory processes - ureaplasmosis, mycoplasmosis, pyelonephritis, bacterial vaginosis. They stimulate the production of prostaglandins. Hormones affect the uterine muscles - cause contractions and premature birth; nine0078
Placental bleeding. They occur with incorrect presentation or detachment. The situation is serious, there is a threat to the life of the mother. Therefore, with presentation, hospitalization is indicated;
Neck weakness. In 20% of cases, it leads to preterm birth. This also includes such factors: the interval between the current and previous gestation is less than 2 years, the woman is expecting 4 children or more;
Isthmic-cervical insufficiency. The cervix opens itself - a miscarriage or premature birth occurs. It is possible to open mechanically - when scraping after a miscarriage, IVF, abortion; nine0078
Pathologies on the part of the baby - intrauterine infection, malformations of internal organs.

Chronic ailments, dental problems, angina, health status during gestation, genetic factors are all common reasons for early delivery. Sometimes it is impossible to determine. Although this is important for the development of effective means of preventing pathology.

Symptoms of preterm labor

We list the signs by which you may suspect that the baby is in a hurry to be born ahead of time. nine0003

Spasms over the pubis. They are similar to pain during menstruation.

Pain, pressure and discomfort in the genitals, thighs, pelvis. There is a dull pain in the lumbar region.

Feeling of pressure, pressure in the back.

Diarrhea, spasms and pain in the intestines.

Vaginal discharge - they get worse. May be watery, pink, brown, bloody.

Contractions of varying intensity. Touch your stomach with your fingertips - you will feel the contraction and relaxation of the uterus. Counted more than 4 contractions in 60 minutes? Call an ambulance - you need an urgent examination by an obstetrician. nine0003

The following symptoms are also dangerous: sudden blurred vision, flashes and “flies” before the eyes, incessant migraine, swelling of the face or hands, temperature of 38º C and above, painful urination, abdominal trauma, decreased fetal activity in the 3rd trimester (less than 10 movements in 12 hours).

Any of the above symptoms indicate the risk of preterm birth. Seek medical attention.

Diagnosis of preterm birth

Includes several stages.

Transvaginal ultrasound. The length of the cervix is measured, fetal fibronectin is determined - a kind of "biological glue" that binds the fetal sac to the uterine mucosa.

Gynecological examination. Allows you to assess the degree of opening of the neck, its length.

Rapid test for the determination of phosphorylated protein-1. The test determines the possibility of preterm birth. In the future, this helps prevent iatrogenic complications. nine0003

When diagnosing, 2 parameters are evaluated:

Regularity of contractions;
Neck changes - shortening and smoothing. informative method. For example, with a neck length of 3 cm, the risk of preterm birth in the next week is 1%. The patient is not admitted to the hospital, there is no danger to her and the fetus.

Differential diagnosis

Its goal is to correctly diagnose. The early birth of a baby is accompanied by cramps in the lower abdomen, diarrhea, pain in the lumbar region. These same symptoms are characteristic of other conditions: appendicitis, colitis, cystitis, pyelonephritis. nine0003

When complaining of pain in the lower abdomen, the patient is examined for the consistency of the scar after the previous cesarean section, for example. When the temperature rises, flu, sore throat, viral infection are excluded.

Diagnosis

Preterm birth is stated based on the clinical picture. Doctors are guided by such markers.

The first is the length of the neck - less than 2 - 2.5 cm.

The second is the determination of phosphorylated protein-1. nine0003

The third is the regularity of contractions. There should be at least 4 in 20 minutes.

Fourth - neck changes in dynamics.

Fifth - assessment of the degree of maturity of the neck. Determined by the level of PSIFR-1 in the cervical canal.

Usually the process begins rapidly, suddenly and intensely.

Treatment for preterm birth

The goal is to reduce the tone of the myometrium, reduce uterine contractions. This is achieved by blocking oxytocin receptors - it is the hormone oxytocin that triggers the birth process. nine0003

Such antagonists of oxytocin receptors are tocolytics. One of the modern representatives of this group of drugs is atosiban.

The remedy is effective, but has contraindications. It is forbidden to treat pregnant women for less than 24 and more than 33 weeks, with uterine bleeding, growth retardation, distress or fetal death, severe preeclampsia, with rupture of the fetal membrane after 30 weeks, placenta previa or its detachment. nine0003

5 stages of management of preterm labor

The first stage is forecasting their onset. Depends on the situation: the process is starting, has begun, or it is a threat.

Stage two - prevention of respiratory distress syndrome in a child. Doctors stimulate the maturation of the lungs. Apply funds from the group of glucocorticoids.

Stage three - prolongation of pregnancy. Doctors try to delay preterm labor by giving the baby's lungs and placenta time to mature. For this, tocolytics are used - they inhibit the contractile activity of the uterus. Usually prophylaxis is carried out - tocolysis is carried out before contractions. When started, therapy is ineffective. The duration of treatment is a maximum of 48 hours. nine0003

Stage four - preparation for the birth of a premature baby. The woman in labor is transferred to a higher-level hospital. The physiology of preterm labor does not differ from the birth of a child at term. But close attention is required from doctors to minimize complications for mom and baby.

The fifth stage is the prevention of infections and their complications. At risk are women in labor whose waters have broken. If the patient gives birth before 34 weeks, she can be pierced with a course of dexamethasone. It accelerates the maturation of the placenta and internal organs of the baby, reduces the risk of complications. nine0003

OB sequence

When registering a patient with preterm birth, the doctor gets acquainted with the exchange card, studies the general, gynecological and infectious anamnesis, and the results of examinations. Clarifies complaints and evaluates the condition of the woman in labor. He examines her, measures the pulse and respiration rate, temperature, pressure, abdominal circumference and the height of the uterus.

Clarifies data on the fetus: movements, measures heart rate by auscultation - listening to the heart through the mother's stomach through the device. To assess the condition of the crumbs, the doctor performs cardiotocography. The device records the heart rate. nine0003

Ultrasound is performed to assess the condition of the child and mother's organs.

A gynecological examination is carried out: with intact membranes - external, with their rupture - internal. This is necessary to determine the position and position of the child, to assess the degree of disclosure.

Conduct a laboratory examination. They take a smear from the vagina: culture for β-hemolytic streptococcus, bacteriological culture, take blood and urine for a general analysis.

According to the results of the examination, the obstetrician confirms or refutes preterm birth, their stage. nine0003

The expectant mother is informed about her condition, forecasts for the child. At the slightest opportunity, they try to prolong the pregnancy. If the child is ready to be born in the near future, the doctor determines the tactics of assistance, coordinates the issue of anesthesia with the woman in labor.

In the absence of indications for a caesarean section, they give birth naturally. This is the best way - it is less traumatic for the baby. A gentle approach is what a weak newborn needs. nine0003

Prematurity Care Policy

The woman in labor is provided with continuous psychological support. Describe the current obstetric situation.

With head presentation, they give birth naturally.

With pelvic - take into account clinical indications. Caesarean section is not the only effective method in this case. The operation does not improve the prognosis for a premature baby, but it puts an additional burden on the mother's body: it increases infection, morbidity, and complications. nine0003

With foot presentation, only a caesarean section is done.

Anesthesia is carefully selected. Avoid opiates - they depress the respiratory center, which is dangerous for premature babies.

At the birth of a baby before 34 weeks, vacuum aspiration is prohibited. It increases the risk of neonatal morbidity. Dosed episiotomy, exit forceps for the birth of the head and epidural anesthesia are performed.

The umbilical cord is clamped at least 1 minute after the baby is born. This tactic reduces the frequency of intraventricular hemorrhage in preterm pregnancies up to 37 weeks of gestation. nine0003

Control the state of the crumbs. CTG is done every hour for 40 minutes, auscultation - periodically.

General recommendations for prevention

You need to think about it from the first trimester. If you want to inform the baby, follow the advice of gynecologists.

Take care of yourself. Rest, avoid nervous overload. Sleep at least 7 hours;
Eat well. Eat foods rich in vitamins, exclude fast food, fatty, fried, spicy and salty foods from the diet. Give up coffee and strong tea; nine0078
Observe the drinking regimen. Try not to feel thirsty - drink water every 2 hours. If you don't want to - don't force yourself;
Avoid physical activity. Active training, hard work, general cleaning alone are taboo for a pregnant woman. Try not to go outside on ice - you may fall, you will strain your muscles - this can increase your tone and provoke premature birth;
Maintain personal hygiene. Wash your face after a bowel movement. Always wash and dry from front to back. This way you will not bring bacteria from the intestine into the vagina. Infections are provocateurs of premature birth; nine0078
Lead a healthy lifestyle. Alcohol and cigarettes are taboo. Smoking pregnant women are predisposed to preterm labor. If you take medications on a regular basis, tell your gynecologist about it. Walk outdoors. Cancel active workouts in favor of leisurely walks in the park;
Register at the antenatal clinic in the first trimester - at 6 ‒ 8 weeks. Visit a gynecologist, listen to him, take tests, undergo ultrasound, screenings;
Be careful with sex. In the first trimester, it is better to limit or abstain from it as much as possible - the embryo must be fixed. With placenta previa and other pathologies, the gynecologist may forbid you to have intimate contacts - listen to him; nine0078
Learn to understand your body. In the 2nd trimester, start listening to the baby: his movements, activity. Fix any changes, strange and unpleasant sensations - and talk about them to the doctor. In case of acute pain, contractions, spasms, blood, urgently call an ambulance - this may be a premature birth;
Maintain bed rest. A gynecologist can advise you to rest. For example, with increased uterine contractions, tone;
Rest every hour. Sit in a chair, lift your legs up. This will relax the muscles, eliminate swelling; nine0078
Be aware of the signs of preterm labor. In case of their threat, you will not miss a moment and consult a doctor. Perhaps the process can be stopped with the help of drugs. Treatment minimizes complications in the premature baby.

Preterm birth prevention

It is divided into 2 stages: before conception and after.

Preventive measures before conception

It is advisable to carry them out to mothers from the risk zone. The gynecologist limits intrauterine manipulations, such as curettage. During IVF, the number of embryos for transfer is regulated taking into account the age of the expectant mother and her health. Inform about the possibility of premature birth at conception through reproductive technologies. nine0003

Hydration is shown - enhanced drinking regimen. It improves fetoplacental blood flow and reduces the risk of preterm birth.

Eliminate infections. It is advisable to do this at the planning stage, since antibiotic treatment during gestation harms the fetus.

It is recommended to postpone the conception of a child soon after the birth of an older brother or sister. Mommy's body needs to recover from the previous pregnancy. It takes him at least 2 years to do this. During this time, the uterus will return to its previous state, strength, vitamin reserves and body reserves will be restored. nine0003

Vitamin complexes are prescribed for predisposition to preterm birth for planning and expectant mothers. Protein-rich dietary supplements are helpful. They strengthen the immune system, improve blood circulation, protect the pregnant woman from infections - and hence the child.

Secondary prevention of early delivery

With the threat of premature birth, the condition of the pregnant woman is monitored at critical periods: from 2 to 12 and from 18 to 22 weeks. During these periods, it is better to stay in the hospital of the perinatal center. Doctors prescribe drugs to maintain and prolong pregnancy. nine0003

Therapy is selected on an individual basis.

With a short neck from 1 to 2.5 cm, progesterone suppositories are prescribed vaginally. The hormone is also shown in previous preterm births. This tactic reduces their risk by 35%. This is a natural hormone. It is efficient and safe. It is prescribed in the first trimester. Synthetic hormone is harmful: it can provoke gestational diabetes.

If there is a threat of early birth of the crumbs, sutures are placed on the neck.

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