What is the average week babies are born

How Many Weeks Early Can You Safely Give Birth?

The end of the third trimester of pregnancy is typically full of both excitement and anxiety for baby’s arrival. It can also be physically uncomfortable and emotionally draining.

If you’re in this stage of pregnancy now, you might be experiencing swelling ankles, increased pressure in your lower abdomen and pelvis, and circling thoughts, such as, when will I go into labor?

By the time you reach 37 weeks, labor induction might seem like a beautiful gift from the universe, but researchers recommend waiting until your baby is full term, unless there are major health concerns for you or your baby.

A full-term pregnancy is 40 weeks long. Although health practitioners once considered “term” to be from week 37 to week 42, those last few weeks are too vital to ignore.

It’s in this final crunch time that your body makes its final preparations for childbirth, while your baby completes the development of necessary organs (like the brain and lungs) and reaches a healthy birth weight.

The risk for neonatal complications is lowest in uncomplicated pregnancies delivered between 39 and 41 weeks.

To give your baby the healthiest start possible, it’s important to remain patient. Elected labor inductions before week 39 can pose short- and long-term health risks for the baby. Deliveries occurring at week 41 or later can have increased complications too.

No two women — no two pregnancies — are the same. Some babies will naturally arrive early, others late, without any major complications.

The American College of Obstetricians and Gynecologists categorize deliveries from week 37 to 42 as follows:

Early term: 37 weeks through 38 weeks, 6 days
Full term: 39 weeks through 40 weeks, 6 days
Late term: 41 weeks through 41 weeks, 6 days
Post-term: 42 weeks and beyond

The earlier your baby is born, the greater the risks to their health and survival.

If born before week 37, your baby is considered a “preterm” or “premature” baby. If born before week 28, your baby is considered “extremely premature.”

Babies born between weeks 20 to 25 have a very low chance of surviving without neurodevelopmental impairment. Babies delivered before week 23 have only a 5 to 6 percent chance of survival.

Nowadays, preterm and extremely preterm babies have the benefit of medical advances to help support the continued development of organs until their level of health is equivalent to that of a term baby.

If you know you’ll have an extremely preterm delivery, you can work with your healthcare practitioner to create a plan for the care you and your baby will receive. It’s important to talk openly with your doctor or midwife to learn all of the risks and complications that may arise.

One of the most important reasons you want to reach full term in pregnancy is to ensure the complete development of the baby’s lungs.

However, there are many factors related to the mom, baby, and placenta which will require the healthcare practitioner, doctor, or midwife to balance the risks associated with reaching full term against the benefit of full lung maturity.

Some of these factors include placenta previa, a prior cesarean or myomectomy, preeclampsia, twins or triplets, chronic hypertension, diabetes, and HIV.

In some cases, delivery earlier than 39 weeks is necessary. If you go into labor early or if your healthcare provider recommends labor induction, it’s still possible to have a positive, healthy experience.

According to the National Center for Health Statistics, most babies are born full term. To be specific:

57.5 percent of all recorded births occur between 39 and 41 weeks.
26 percent of births occur at 37 to 38 weeks.
About 7 percent of births occur at weeks 34 to 36
About 6.5 percent of births occur at week 41 or later
About 3 percent of births occur before 34 weeks of pregnancy.

Some women experience recurrent preterm deliveries (having two or more deliveries before 37 weeks).

Just like having a previous preterm baby is a risk factor for having another preterm baby, women with a prior post-term delivery are more likely to have another post-term delivery.

The odds of having a post-term birth increase if you are a first-time mother, having a baby boy, or obese (BMI greater than 30).

Most of the time, the cause of a premature birth remains unknown. However, women with a history of diabetes, heart disease, kidney disease, or high blood pressure are more likely to experience preterm deliveries. Other risk factors and causes include:

pregnant with multiple babies
bleeding during pregnancy
misusing drugs
getting a urinary tract infection
smoking tobacco
drinking alcohol during pregnancy
premature birth in a previous pregnancy
having an abnormal uterus
developing an amniotic membrane infection
not eating healthy before and during pregnancy
a weak cervix
a history of an eating disorder
being overweight or underweight
having too much stress

There are many health risks for preterm babies. Major life-threatening issues, like bleeding in the brain or lungs, patent ductus arteriosus, and neonatal respiratory distress syndrome, can sometimes be successfully treated in the neonatal intensive care unit (NICU) but often require long-term treatment.

Other risks involved with preterm deliveries include:

developmental delays
trouble breathing
vision and hearing problems
low birth weight
difficulties latching onto the breast and feeding
jaundice
difficulty regulating body temperature

Most of these conditions will require specialized care in a NICU. This is where the healthcare professionals will perform tests, provide treatments, assist breathing, and help feed premature infants. The care a newborn receives in the NICU will help ensure the best quality of life as possible for your baby.

Things to know about the NICU

For families who do end up with a baby in the NICU, there are a few simple things that can make a huge difference for baby’s overall health and recovery.

First, practicing kangaroo care, or holding baby directly skin to skin has been shown to reduce rates of mortality, infection, illness, and the length of hospital stay. It can also help parents and babies bond.

Second, receiving human breast milk in the NICU has been found to improve survival rates and dramatically reduce rates of a severe gastrointestinal infection called necrotizing entercolitis compared to babies who receive formula.

Moms who give birth to a preterm baby should start pumping breast milk as soon as possible after birth, and pump 8 to 12 times per day. Donor milk from a milk bank is also an option.

Doctors and nurses will watch your baby as they grow to ensure proper care and treatment, if it’s necessary. It’s important to stay informed, find the appropriate specialized care, and remain consistent with any future treatments and appointments.

Though there are no magical spells to ensure full-term pregnancies, there are a few things you can do on your own to lower your risk of early labor and birth.

Before getting pregnant

Get healthy! Are you at a healthy weight? Are you taking prenatal vitamins? You’ll also want to cut back on alcohol, try to stop smoking, and not misuse any drugs.

Exercise regularly and try to eliminate any unnecessary sources of stress from your life. If you have any chronic health conditions, get treated and remain consistent with treatments.

During pregnancy

Follow the rules. Eat healthy and get the proper amount of sleep. Exercise regularly (be sure to check with your healthcare provider before beginning any new exercise routine during pregnancy).

Go to every scheduled prenatal appointment, give an honest and thorough health history to your healthcare provider, and follow their advice. Protect yourself from potential infections and sickness. Make an effort to gain the appropriate amount of weight (again, talk to your OB about what’s ideal for you).

Seek medical attention for any warning signs of preterm labor, such as contractions, constant low back pain, water breaking, abdominal cramps, and any changes in vaginal discharge.

After delivery

Wait at least 18 months before trying to conceive again. The shorter the time is between pregnancies, the greater the risk for a preterm delivery, according to the March of Dimes.

If you’re older than 35, talk to your healthcare provider about the appropriate amount of time to wait before trying again.

Giving birth unexpectedly to a premature or post-term baby can be stressful and complicated, especially when it can’t be prevented. Talk with your doctor or midwife and stay informed.

Learning as much as you can about the procedures and treatments available to you and your baby will help lower anxieties and give you a sense of control.

Keep in mind that the options and support for premature babies have improved over the years, and the odds of leaving the hospital with a healthy baby are higher than ever before. The more you know, the better prepared you’ll be to provide your little one with all of the love and care they deserve.

Why at least 39 weeks is best for your baby

If your pregnancy is healthy, it’s best to stay pregnant for at least 39 weeks.

Wait for labor to begin on its own.

Scheduling means you and your provider decide when to have your baby by labor induction or cesarean birth.

If your provider recommends scheduling your baby’s birth, ask if you can wait until at least 39 weeks so your baby has time to fully develop.

Your baby’s brain, lungs, liver and other important organs are still developing in the last weeks of pregnancy.

Babies born too early may have more health problems at birth and later in life than babies born later.

Are you thinking about scheduling your baby’s birth?

Scheduling your baby’s birth means you and your health care provider decide when to have your baby by labor induction or cesarean birth instead of waiting for labor to begin on its own. Depending on your health and your baby’s health, scheduling your baby’s birth may be best. But scheduling birth a little early for non-medical reasons can cause problems for you and baby. If your pregnancy is healthy, it’s best to stay pregnant for at least 39 weeks and wait for labor to begin on its own.

When you schedule your baby’s birth, you schedule either labor induction or a c-section. Labor induction (also called inducing labor) is when your provider gives you medicine or breaks your water (also called amniotic sac) to make your labor begin for vaginal birth. Vaginal birth is when the muscles of your uterus contract (get tight and then relax) to help push your baby out through the vagina (also called birth canal). Most babies are born by vaginal birth. A cesarean birth (also called c-section) is surgery in which your baby is born through a cut that your provider makes in your belly and uterus.

You may not have a choice about when to have your baby. If there are problems with your pregnancy or your baby's health, you may need to have your baby early. But if you have a choice and you're planning to schedule your baby's birth, wait until at least 39 weeks.

Why does your baby need 39 weeks?

Babies born too early may have more health problems at birth and later in life than babies born later. Being pregnant 39 weeks gives your baby's body all the time it needs to develop.

Your baby needs 39 weeks in the womb because:

Important organs, like your baby’s brain, lungs and liver, need time to develop. The brain develops fastest at the end of pregnancy. A baby’s brain at 35 weeks of pregnancy weighs only two-thirds of what it will weigh at 39 to 40 weeks.
He’s less likely to have health problems after birth, like breathing, vision and hearing problems.
He can gain more weight in the womb. Babies born at a healthy weight have an easier time staying warm than babies born too small.
He can suck and swallow and stay awake long enough to eat after he's born. Babies born early sometimes can't do these things.
He’s less likely to have learning problems and health problems later in life than babies born before 39 weeks.

Can scheduling an early birth cause problems for you and your baby?

Yes. Sometimes it's hard to know exactly when you got pregnant. Even with an ultrasound, your due date can be off by as much as 2 weeks. If you schedule an induction or c-section and your date is off by a week or 2, your baby may be born too early. Ultrasound uses sound waves and a computer screen to show a picture of your baby inside the womb.

Problems from inducing labor

Stronger and more frequent contractions. Frequent contractions may cause changes in your baby’s heart rate.
Infection for you and your baby
Uterine rupture. This is when the uterus tears during labor. It happens very rarely.
Needing a c-section. If your labor is induced and the medicine doesn’t start your labor, you may need to have a c-section.

Problems from a c-section

Breathing and other medical problems for your baby. Babies born by c-section may have more breathing and other medical problems than babies born by vaginal birth.
Needing a c-section in another pregnancy. Once you have a c-section, you may be more likely in future pregnancies to have a c-section. The more c-sections you have, the more problems you and your baby may have, including problems with the placenta.
Longer recovery for mom. A c-section is major surgery. It takes longer for you to recover from a c-section than from a vaginal birth. You can expect to spend 2 to 4 days in the hospital after a c-section. Then you need about 6 to 8 weeks after you go home to fully recover. You also may have complications from the surgery, like infections, bleeding or blood clots. So it's important to stay in touch with your health care provider even after you go home.

What questions can you ask your health care provider about scheduling your baby's birth?

If you’re planning to schedule your baby’s birth, print out this article and take it with you to your next prenatal care checkup. Ask these questions:

If your provider recommends that you have your baby before 39 weeks

Is there a problem with my health or the health of my baby that makes birth before 39 weeks necessary?
Can I wait to have my baby until I’m closer to 39 weeks?

About inducing labor

Why do you need to induce labor?
How will you induce my labor?
What can I expect when you induce labor?
Will inducing labor increase the chance that I’ll need to have a c-section?

About having a c-section

Why do I need to have a c-section?
What can I expect during and after a c-section?
What problems can a c-section cause for me and my baby?
Can I have a vaginal birth in future pregnancies?

See also: 39 weeks infographic

Last reviewed: October, 2018

Premature birth - Juno

Premature birth: content of the article

What is preterm birth

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.

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;
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.

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;
Early initiation of intimate life;
Hereditary factor;
Pathologies of previous pregnancy: preeclampsia, fetoplacental insufficiency, premature birth;
Excessive uterine distension in multiple pregnancies, polyhydramnios;
Threat of early miscarriage.

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

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.

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.

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.

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 .

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.

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;
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;
According to 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;
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;
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.

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.

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.

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.

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.

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.

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.

5 stages 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.

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.

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.

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.

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.

Preterm birth 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.

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.

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;
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;
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;
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;
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.

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.

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.

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. The expectant mother is out of the risk zone in this situation, stitches may not be applied.

Another option is to install a pessary on the neck.

These methods reduce the statistics of premature births. But the mortality rate of newborns is not affected.

When carrying twins, circular or U-shaped sutures can be applied. In most cases, such tactics with a short neck in multiple pregnancies can provoke preterm labor. Vaginal progesterone is not prescribed.

For infections (for example, bacteriuria, gonococcus, syphilis, β-hemolytic streptococcus, bacterial vaginosis, chlamydia), antibiotic prophylaxis is prescribed. Depending on the diagnosis, penicillin, ampicillin, metronidazole, erythromycin, ceftriaxone, josamycin may be prescribed.

Terminals

Premature birth is one of the fears of many expectant mothers. Nobody is immune from this. But you can minimize the risks. Follow the recommendations of the gynecologist, take care of yourself, listen to your body, do not refuse to stay in the perinatal center.

Don't think bad. Modern medicine successfully nurses premature babies, reduces the risks of complications and consequences.

Obstetrician-gynecologist of the first qualification category -
Panasenko Irina Gennadievna

Medical myths about childbirth: about the exact date, spicy food and waste of water

Claudia Hammond
BBC Future

December 3, 2017

understand the events.

Image copyright, iStock

Some of the myths about childbirth, about what affects childbirth and how it goes, have been formed for a long time and hold on to our minds unusually strong. Browser BBC Future questions three of them.

1. During the first pregnancy, childbirth occurs later

The truth is that only 4% of children are born at term. Very often, childbirth comes later, but just as often - earlier.

When computer scientist Allen Downey of Olin Technical College (Massachusetts, USA) studied data from a 2002 survey conducted by the Federal Agency for Disease Control and Prevention, he found that first pregnancies were less likely to have a full term delivery than first pregnancies. second (and so on) pregnancy.

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Yes, his analysis of the data confirmed that the first child is often born later than expected. But it is just as likely (compared to the second or third child) that he will be born prematurely.

Downey did find that first pregnancies were delivered on average a little later than subsequent pregnancies, but only by 16 hours (average) if we are talking about full-term babies.

But since we decided to deal with all babies, I think it's fair to include those who are born prematurely in our study.

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It may seem strange, but very few babies are born at term

16 hours is not much, so the notion that babies are usually born a few hours late in first pregnancies days, or even a week, is not true.

This, of course, sometimes happens, and stories about it can often be heard from the lips of those who witnessed them. However, if we are looking for general trends, individual personal histories are unlikely to help.

It may seem strange to some that so few babies are born at term, but perhaps there is nothing surprising in this.

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The due date is usually calculated from the date of the last menstrual period. Not every woman can accurately remember this day.

Also, it's a big question whether we should expect each pregnancy to last the same number of weeks.

In one study, scientists measured hormone levels in the urine of women who were trying to get pregnant every day.

This made it possible to accurately determine when fertilization occurred and calculate the correct duration of pregnancy. As a result, it turned out that the terms may differ in some cases by as much as five weeks. (According to some experts, in general, a woman has only a 4-5% chance of giving birth at the calculated date. - Translator's note. )

In the case of a second or third pregnancy, the estimated date of delivery may also depend on the interval between pregnancies.

According to research, if conception occurs within the first year after the birth of a child, the second pregnancy is often shorter.

Some believe that it is necessary to abolish the indication of the exact date of birth altogether. Instead, women should be given a later date and told that they will have had a baby by then.

This will result in 96% of couples who are expecting their first child being spared endless worry and stress about the "right" due date.

2. Spicy food can induce labor

When the calculated due date passes and the baby doesn't even think of being born, a good half of women decide to take matters into their own hands.

At any rate, according to one study, more than one-fifth of those pregnant American women who hope to induce labor turn to spicy curry.

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The theory behind this is this: a spicy dish can increase peristalsis (wave-like contraction of the walls of the esophagus, stomach, intestines, ureters, etc. , contributing to the promotion of their contents to the exit openings. - Translator's note ) - which, in turn will cause uterine contractions.

This method has never been studied scientifically. From time to time there are calls for a full-scale study to understand what can and cannot start the process of childbirth.

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It has long been believed that spicy foods can induce labor

But even if spicy foods can induce labor in some women, the effectiveness of this method also depends on the individual tolerance of acute and on your eating habits.

If you eat spicy foods daily, it may not work at all or have a strong effect.

3. Amniotic fluid always drains suddenly and in large quantities

In films, we often see how an actress playing a woman at a long pregnancy stage depicts fright on her face due to the fact that fluid has (as we guess) gushed out of her, contractions immediately begin, the woman grabs her stomach and her immediately taken to the hospital.

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