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Preterm labour

Preterm labour

Care and treatments for women during threatened premature (or preterm) labour will often involve procedures to check the wellbeing of the baby and mother, assess the woman's cervix and sometimes precautionary steps 'just in case' the baby(s) are born early. These can include:

     
Admission to hospital
     
Assessing the cervix
     
Ultrasound
     
Transfer to another hospital
     
Steroid injections
     
Contraction suppressants

Admission to hospital. Admission to hospital is recommended for monitoring the baby's heart rate and assessing the regularity, length and intensity of the contractions. Some women may need to stay in hospital for a period of time (hours or a couple of days) until the contractions settle down and / or the caregiver is satisfied that everything appears to be OK for the time being.

If the labour appears to be intensifying and the birth appears imminent, the caregiver may organise for the woman to transfer to another hospital with a Level 3 Intensive Care Nursery. This would be the case if the baby(s) were moderately or extremely premature (32 to 34 weeks or less).

Assessing the cervix. The caregiver will usually try and assess whether the woman's cervix is thinning and dilating. Sometimes this is difficult to tell if there have been no previous vaginal examinations to compare the cervix with. Therefore the caregiver may perform an internal vaginal examination every few hours (while the contractions are happening) to see whether there are any changes.

The caregiver may perform an internal vaginal examination using their fingers to gently feel the cervix, or they may use a speculum (the instrument used for a pap test) to look at the cervix to see if it is dilating. If the waters have broken then a speculum will most likely be used to reduce the chances of infection, as the instrument is sterilised and does not need to touch the cervix. Some caregivers will use an ultrasound to assess the cervix.
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