Premature Delivery and Preterm Birth

Preterm labor is one of the major concerns in pregnancy because it is a leading cause of infant mortality and morbidity, and the most common reason for hospital admissions before delivery. With proper management, proven medical tools, and timely medical care, it is possible to significantly reduce risks for both mother and baby. In this article, we explain how to recognize it, what treatment is available, and how to reduce the risk of preterm labor.

Information about possible preterm labor

If you are not yet pregnant or are in early pregnancy, it is important during your first visit with your doctor to ask what to do if you have concerns or symptoms that may indicate preterm labor. Each health plan offers different options: gynecologist, hotline, and emergency department.

Ask your doctor for a detailed explanation of how to access care at any time of day or night, especially in cases of early contractions.

Diagnosis of preterm labor

Early detection is very important, as it allows the medical team to intervene in time and sometimes even delay delivery and improve the baby’s chances of survival. The diagnosis of preterm labor is based on uterine contractions accompanied by changes in the cervix before 37 weeks of pregnancy.

If you are at this stage and feel regular contractions (every 5 to 10 minutes), you should contact your health fund’s medical hotline or your healthcare provider and come in for an ultrasound examination. If the results show a shortened cervix or dilation, this is an initial suspicion of preterm labor.

It is important not to ignore symptoms, as timely intervention may help delay labor.

Prevention of preterm labor

In women with a history of spontaneous preterm birth before 37 weeks, or preterm birth following premature rupture of membranes, progesterone treatment may be considered during pregnancy. In cases of suspected cervical insufficiency, cervical cerclage (stitching of the cervix) may be considered.

Predicting preterm labor

Not every suspicion of preterm labor results in immediate delivery. Fewer than 10% of women with a clinical diagnosis of preterm labor will deliver within one week of diagnosis. There are two main tools used to help predict risk and guide treatment decisions:

• Fetal fibronectin (fFN): A swab test taken from the vagina that helps predict whether delivery will occur within one week. A positive result indicates a higher chance of preterm birth, while a negative result indicates a very low risk.
• Transvaginal cervical length measurement: If the cervix measures less than 25 mm, there is an increased risk of preterm labor. If cervical length is above 25–30 mm and the fFN test is negative, the risk of delivery within one week is low.

Important: These tests are performed in women with symptoms of preterm contractions, especially before 34 weeks of pregnancy.

Medication treatment to prevent preterm labor

Medication treatment is called tocolytic therapy and is carried out using medications that relax the uterus, stop contractions, and delay delivery by 48 hours. It is important to know that 48 hours is enough time to administer steroids to help mature the fetus’s lungs, which improves its chances of survival.