Premature Delivery

A birth that takes place before the 37th week of pregnancy

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What causes low amniotic fluid during pregnancy

The amniotic fluid is part of the baby’s life support system. It protects your baby and aids in the development of muscles, limbs, lungs and digestive system. Amniotic fluid is produced soon after the amniotic sac forms at about 12 days after conception.  It is first made up of water that is provided by the mother, and then around 20 weeks fetal urine becomes the primary substance. As the baby grows he or she will move and tumble in the womb with the help of the amniotic fluid. In the second trimester the baby will begin to breathe and swallow the amniotic fluid. In some cases the amniotic fluid may measure too low or too high.  If the measurement of amniotic fluid is too low it is called oligohydramnios.  If the measurement of amniotic fluid is too high it is called polyhydramnios. What is oligohydramnios? Oligohydramnios is the condition of having too little amniotic fluid.  Doctors can measure the amount of fluid through a few different methods, most commonly through amniotic fluid index (AFI) evaluation or deep pocket measurements. If an AFI shows a fluid level of less than 5 centimeters (or less than the 5th percentile), the absence of a fluid pocket 2-3 cm in depth, or a fluid volume of less than 500mL at 32-36 weeks gestation, then a diagnosis of oligohydramnios would be suspected. About 8% of pregnant women can have low levels of amniotic fluid, with about 4% being diagnosed with oligohydramnios. It can occur at any time during pregnancy, but it is most common during the last trimester.  If a woman is past her due date by two weeks or more, she may be at risk for low amniotic fluid levels since fluids can decrease by half once she reaches 42 weeks gestation. Oligohydramnios can cause complications in about 12% of pregnancies that go past 41 weeks. What causes low amniotic fluid? Birth defects – Problems with the development of the kidneys or urinary tract which could cause little urine production, leading to low levels of amniotic fluid. Placental problems – If the placenta is not providing enough blood and nutrients to the baby, then the baby may stop recycling fluid. Leaking or rupture of membranes –This may be a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes (PROM) can also result in low amniotic fluid levels. Post Date Pregnancy– A post date pregnancy (one that goes over 42 weeks) can have low levels of amniotic fluid, which could be a result of declining placental function. Maternal Complications– Factors such as maternal dehydration, hypertension, preeclampsia, diabetes, and chronic hypoxia can have an effect on amniotic fluid levels. What are the risks of having low amniotic fluid? The risks associated with oligohydramnios often depend on the gestation of the pregnancy. The amniotic fluid is essential for the development of muscles, limbs, lungs, and the digestive system. In the second trimester, the baby begins to breathe and swallow the fluid to help their lungs grow and mature. The amniotic fluid also helps the baby develop muscles and limbs by providing plenty of room to move around. If oligohydramnios is detected in the first half of pregnancy, the complications can be more serious and include: Compression of fetal organs resulting in birth defects Increased chance of miscarriage or stillbirth If oligohydramnios is detected in the second half of pregnancy, complications can include: Intrauterine Growth Restriction (IUGR) Preterm birth Labor complications such as cord compression, meconium stained fluid and cesarean delivery What treatments are available if I am experiencing low amniotic fluid? The treatment for low levels of amniotic fluid is based on gestational age. If you are not full term yet, your doctor will monitor you and your levels very closely. Tests such as non-stress and contraction stress test may be done to monitor your baby’s activity. If you are close to full term, then delivery is usually what most doctors recommend in situations of low amniotic fluid levels. Other treatments that may be used include: Amnio-infusion during labor through an intrauterine catheter.  This added fluid helps with padding around the umbilical cord during delivery and is reported to help lower the chances of a cesarean delivery. Injection of fluid prior to delivery through amniocentesis.  The condition of oligohydramnios is reported to often return within one week of this procedure, but it can aid in helping doctors visualize fetal anatomy and make a diagnosis. Maternal re-hydration with oral fluids or IV fluids has shown to help increase amniotic fluid levels. content source

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Abdominal pain during pregnancy

Abdominal pain during pregnancy can happen quite often and can become very uncomfortable at times. But how do you decide what pain is acceptable and when it indicates something more serious? Here’s everything you need to know about abdominal pain during pregnancy.   Is abdominal pain during pregnancy normal? Abdominal pain is a common occurrence during pregnancy and is normal in a healthy pregnancy. Carrying a baby puts pressure on your muscles, joints, veins. As your baby grows, the uterus tilts to the right which causes pain in the right side. The ligaments on both sides of your body grow to accommodate your growing baby so you may feel pain on both sides of the stomach. Having sex may sometimes trigger abdominal pain and cramping, especially during the third trimester. It might be a good idea to keep the sex soft at this time.   How to deal with normal abdominal pain during pregnancy? Getting some rest is the best way to deal with the cramps. Other methods include sitting down with your feet up, lying on the side opposite to the one which hurts, taking a warm bath, and using a hot water bottle or a heated wheat bag on the area which hurts. When can abdominal pain mean something more? Abdominal pain can be an indicator of something more under the following circumstances.   Abdominal pain unrelated to pregnancy This could be gas, bloating, UTI, kidney stones or even appendicitis. You should contact your doctor if the pain is accompanied by pain or burning when you pee, spotting or bleeding, vomiting, unusual vaginal discharge, tenderness and pain, chills and fever.   Abdominal pain during an early miscarriage or ectopic pregnancy If abdominal pain is accompanied by bleeding in your first trimester it could be an early miscarriage. You may also have painful cramping and dark, watery blood if you have an ectopic pregnancy in your first trimester. In either case, it’s best to go to the doctor immediately.   Abdominal pain during a late miscarriage Abdominal pain in the second trimester is usually nothing to worry about. In rare cases, it may indicate a late miscarriage only if it’s accompanied by bleeding. It usually occurs between 12 and 24 weeks.   Abdominal pain in the third trimester Severe abdominal pain in the third trimester could be an indicator of premature labour. In this case, you would feel pain in your pelvic or lower tummy area, backache, mild tummy cramps and diarrhoea. You may even have your water breaking, and regular contractions, or uterus tightening. This may happen between 24 weeks and 37 weeks of pregnancy and your doctor should be consulted immediately.    

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Never miss these top 10 vital signs and symptoms of labour

While there are characteristic changes in the body with impending labour, every woman's experience is unique and different. "Normal" can vary from woman to woman. The signs and symptoms of normal labor can begin three weeks prior to the anticipated due date up until two weeks afterward, and there is no precise way to predict exactly when a woman will go into labor. This article describes the 10 most common signs and symptoms that labor is approaching. 1. The baby drops Medically known as "lightening," this is when the baby "drops." The baby's head descends deeper into the pelvis. For some women, this occurs up to 2 weeks prior to the beginning of labor; other women may not notice this event at all. 2. An increased urge to urinate An increased urge to urinate can be a result of the baby's head dropping into the pelvis. The low position of the baby's head puts even more pressure on the urinary bladder, so many women approaching labor might feel a frequent need to urinate. As the baby drops, breathing can become easier since there is less pressure on the diaphragm from underneath. 3. The mucus plug passes Passage of the mucus plug is a known sign that labor is near. Thick mucus produced by the cervical glands normally keeps the cervical opening closed during pregnancy. This mucus plug must be expelled before delivery. Pressure from the baby's head causes the mucus plug to be expressed from the vagina, sometimes as blood-tinged vaginal discharge (referred to as "bloody show"). For some women, the mucus plug is not expelled until after labor begins; others may notice the mucus discharge in the days prior to the onset of labor. 4. The cervix dilates Dilation of the cervix is a sign that labor is approaching, although this is detected by the health-care professional during a pelvic examination. This begins in the days and even weeks prior to the onset of labor; "Fully dilated" means the cervix has dilated to a width of 10 cm. 5. Thinning of the cervix In addition to dilation, thinning (effacement) of the cervix also occurs. This occurs in the weeks prior to labor, since a thinned cervix dilates more easily. This sign is also detected by the health-care professional during a. 6. Back pain Many women note they experience back pain, especially dull pain in the lower back that comes and goes, as labor approaches. Back pain may accompany contractions felt in other locations or may occur on its own. Women also notice loosening of the joints, particularly in the pelvic area, as the third trimester progresses, in preparation for delivery. 7. Contractions Contractions, which can vary among women and can be described as pounding, tightening, stabbing, or similar to menstrual cramps, increase in strength and frequency as labor approaches. Irregular contractions, known as Braxton-Hicks contractions or "false labor," occur toward the end of pregnancy during the third trimester. Braxton-Hicks contractions are usually milder than those of true labor, and they do not occur at regular intervals. When contractions begin to occur less than ten minutes apart, this frequently signals the onset of true labor. 8. A burst of energy In contrast to feeling extra tired as is typical of pregnancy, many women describe feeling a sudden burst of energy and excitement in the weeks prior to labor. Often referred to as "nesting," this impulse often is accompanied by a sense of urgency to get things done or make plans for the baby. 9. Feeling the urge to have a bowel movement (diarrhea) Women often describe the pelvic pain and pressure as feeling the urge to have a bowel movement. Some women also report experiencing diarrhea or loose bowel movements in the days preceding labor. 10. Your water breaks Rupture of the amniotic membranes, or one's "water breaking," usually is a sign that labor has begun. Despite how it is often portrayed in movies, it is typically not a dramatic gush of fluid, but rather a slower dripping or trickle. Amniotic fluid should be colorless and odorless. It can sometimes be hard to distinguish from urine, but amniotic fluid does not have an odor. If you are leaking amniotic fluid, it is essential to contact your health-care professional right away.

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When does your labour really start? 6 early signs & symptoms

There are a number of different signs that may indicate that labour is not too far away. These can occur as much as a week or more before labour begins. You may also feel contractions that make you think you’re experiencing the real thing, but turn out to be practice contractions. Wondering whether you’ll know when you are in early labour? You can find a list of the most common signs of labour given below:  Common Labour Signs Although every labour is different and there is no definite set of events, some common early signs of labour include: Lightening Your baby drops lower into your pelvis in the weeks or hours before labour. This is called lightening because you may find breathing a little easier as your baby will no longer be pressing against your diaphragm. On the other hand, you may feel like you need to urinate more often. A Change in Energy Levels You may be feeling extra tired or experiencing a sudden surge of energy in the days or weeks before labour. You might also have the urge to nest and get prepared for the baby. Bloody Show You might notice a thick, pinkish or blood-streaked discharge called a bloody show. This is the mucus plug that sealed your cervix during pregnancy. It usually appears within the two weeks before labour, although it’s not always noticeable. Water Breaking Water breaking is one of the most common labour signs, usually taking place up to a day before delivery (but sometimes only during active labour), when the amniotic sac ruptures and releases the fluid inside. You could experience a gush of water or just a trickle. If your water breaks, notify your doctor or midwife. Early Contractions These feel like menstrual cramps every 20 to 30 minutes, gradually becoming stronger and more frequent. When the contractions occur every three to five minutes, you’re in active labour. Time your contractions, or have someone time them for you. Diarrhoea Loose bowels could be an extra indicator that you’re going into labour. Definitely call your doctor or midwife if you notice bright red bleeding (not pale pink or dark brown), if your water breaks (especially if the fluid is green or brown or has a foul odour), if your baby is less active, or if you have a headache, vision problems, or sudden swelling, particularly in your face and hands. Also call your doctor if you are experiencing these symptoms before 37 weeks when they could signal preterm labour. What to Do When in Early Labour Don’t panic if you only experience a few signs of labour approaching, because many women don’t notice all of them. If you think you are in labour, call your doctor or midwife, whether it’s day or night. Tell them your symptoms of labour, and keep in mind you may not need to go to the hospital immediately. Your doctor or midwife will give you guidance based on your labour signs and your individual situation. Realising you're in labour can bring feelings ranging from excitement to disbelief or apprehension. Try to stay calm and focused. Arrange to have your partner or a family member with you to help record labour symptoms, keep you company, and get you to the hospital when the time comes. How to Tell Real and False Labour Signs Apart In your third trimester you may get ‘false’ or ‘practice’ contractions known as Braxton Hicks. These contractions may feel like the real thing, but if they don’t get stronger and closer together or come with other signs of labour, there is no need to call your doctor. These practice contractions are just one of the ways your body prepares for labour and nothing to worry about. Keep an eye out for specific symptoms that point towards real labour, such as the bloody show or any of the symptoms above. But to help you tell the difference between true and false labour contractions at a glance, see our table below. True Labour False Labour Contractions are regular and follow a predictable pattern (such as every eight minutes). Contractions are irregular and unpredictable, occurring, for example, in intervals of ten minutes, then six minutes, two minutes, eight minutes, etc. You experience three types of progression: contractions become closer in time, longer, and stronger. No progression is seen over time in the closeness of the contraction intervals, length, or strength of the contractions. Each contraction is felt starting at the lower back, radiating around to the front, low in the groin. Contractions are felt as a generalised abdominal tightening. A change in activity or position will not slow or stop contractions. A change in activity or position may cause contractions to slow or stop.   False labour pain can be triggered by a variety of causes, such as dehydration or a full bladder, or even when the mother and baby are active. But if you feel any of the symptoms of labour or notice that your contractions are getting closer together and more intense, then consult your healthcare provider. As you reach the end of your third trimester, the big day is coming up. To help you feel prepared, see our labour tips to help reduce any anxiety you may feel when you notice those early labour signs. You’re about to bring your baby into the world. You can do this! Content source Featured image source

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