How to give birth early: methods, tips and reviews. Why are babies born prematurely? The exact way to give birth prematurely

Pregnancy is the most emotional period in the life of every woman, and what closer deadline childbirth, the more worried and worried the expectant mother. The 40th week of pregnancy is coming, the mother is looking forward to the long-awaited contractions, but they still do not start. The last days of gestation drag on for a long time, and the baby still does not want to get out into the big world.

When the day passes, on which the doctors suggested childbirth, mommy becomes really anxious. Is everything okay with the baby? How much longer to wait for his birth? Can you induce contractions on your own? Every pregnant woman wants to get rid of a heavy burden as soon as possible, to press her beloved baby to her chest. There are several fairly effective ways to speed up labor at 40 weeks of gestation, the only question is whether this is necessary.

When should you give birth?

Pregnancy ideally lasts exactly forty weeks, or ten lunar months, but the child may be born prematurely, or it may linger in the womb. It is not considered a deviation from the norm if the baby decides to get out of the abdomen already at 38 or only at 42 weeks. In the first case, the baby is fully formed, continues to grow and gain weight, and in the second case, he still does not show signs of postmaturity.

A woman's body manifests itself very individually, but it is possible to approximately calculate how long the pregnancy will be by the duration of her menstrual cycle. If menstruation is repeated after 28 days, then the child is likely to be born exactly at the time determined by the doctors, if menstrual cycle takes more than 30 days, then the gestation will be long.

If for some reason the baby is born before 38 weeks, he is considered premature and is subject to nursing in the postpartum department. And if the baby is born later than 42 weeks, he has all the signs of postmaturity, which also does not reflect very well on his health.

The doctor informs the expectant mother at the first appointment at the antenatal clinic, and a more accurate date is determined during the examination by an ultrasound machine, when the doctor observes the degree of development of the embryo. At the 40th week of pregnancy, if there are no pathologies or complications, childbirth takes place in a natural form. But under certain conditions, the doctor may prescribe a caesarean section.

Is it really necessary to induce labor?

Whether it is worth stimulating labor at the 40th week of pregnancy, only the doctor can say after the examination. If the baby in the womb grows and develops normally, there is enough space for him, the mother need not worry, waiting for the natural birth process. In this case, it is better not to intervene during pregnancy.

But if the baby is large, he may not have enough oxygen from the aging placenta. A post-term infant who does not want to get out of their abdomen experiences oxygen starvation. In addition, after the 40th week of pregnancy, the bones of the skull begin to harden in the fetus, which means that it will be very difficult for him to move through the birth canal, and the mother will experience severe pain during childbirth. In this situation, in order not to wait for a referral to a caesarean section, a pregnant woman is advised to induce labor.

How to induce labor at home?

Already at 39 weeks, doctors begin to frighten a pregnant woman with artificial induction of labor with the use of medications. Not a single mother wants to poison either herself or the unborn baby with medicines, so many people think about how to cause contractions at home. There are many ways to independently cause contractions and childbirth, the doctor can tell you in detail about them in the antenatal clinic. Women who have firmly decided to give birth should have a good rest and sleep, because childbirth is a long and tiring process.

Hiking. Vigorous walking in the fresh air is useful at any period of gestation: it increases the tone of the body and gives it a good shake, bringing the birth closer.
Physical exercise. Many women admit that their contractions began as soon as they finished cleaning the house. The main thing is not to overwork, so as not to provoke placental abruption instead of childbirth. You can wash floors, dust furniture, take out the trash, bathe an older child in the bath, wash clothes, but you can’t carry heavy buckets, lift loaded boxes and bags of groceries.
Sex. natural and very effective way speed up childbirth at home, especially if the intimate process ends with an orgasm. Spermatozoa in high concentrations contain the hormone prostaglandin, which helps soften the tissues of the uterus, and orgasm causes its active contraction, which can gradually develop into labor pains.
Breast massage. Intense stimulation of the breast in the area around the nipples provokes the production of the hormone oxytocin, which is responsible for the onset of the birth process.
Laxatives. Increased peristalsis of the intestinal tract not only helps to speed up labor, but also cleanses the body, which makes it possible to avoid liquid stool during fights. A good laxative for pregnant women is ordinary castor oil, one tablespoon is enough to induce contractions. Also, in the last days of gestation, it is advisable to eat more fresh fruits and vegetables, cereal cereals.
Folk remedies. Strong tea from raspberry leaves activates labor activity, softens the tissues of the cervix, but it should not be taken until the 40th week of pregnancy. This is a very strong remedy that can cause miscarriage in the early stages. A carefully whipped mixture of sparkling water, apricot, almonds and castor oil also helps to quickly stimulate labor.
Linseed oil. The components contained in it make the tissues of the uterus and birth canal soft and elastic, preparing them for the upcoming birth. If you have an allergic reaction to flax oil, you can replace it with evening primrose oil.
Fragrances. It is believed that the smell of certain flowers, especially rose or jasmine, can cause contractions. A woman who wants to give birth as soon as possible late term, can carry out aroma therapy at home using flower oils. The main thing is not to cause allergies.
Acupuncture. This method of inducing labor is best left to a specialist. The master, with the help of the finest needles, acts on the points of the body responsible for the functioning of the uterus. This technique quite often contributes to the occurrence of contractions.

Pregnancy lasts 40 weeks, with slight fluctuations in both directions. But for health reasons or because of too much desire, pregnant women are looking for ways to give birth ahead of schedule. This is not safe, so the situation requires deep study.

Causes

Premature birth of a child is always a risk, because the baby is not yet fully formed and strong. If the baby was born before 37 weeks, then the birth was premature.

The situation is influenced by social and medical factors, the time of the year during which the main period of gestation falls. Autumn and spring are peak seasons for flu and colds. Severe infectious diseases cause childbirth long before due date.

Social causes of early childbirth:

studies;
lack of legalized relations;
family problems;
malnutrition;
bad habits;
environmental situation at the location of the expectant mother.

All these components push the baby to be born earlier. If a woman is constantly in nervous tension due to sessions and exams, or feels the pressure of society through the absence of her husband, this prevents the pregnancy from proceeding fully. There is a risk of premature birth of a child.

The expectant mother, in order not to give birth prematurely, must fully eat and drink complex vitamins to saturate the fetus with useful substances.

Bad habits are excluded: smoking, taking drugs or excessive alcohol consumption, both before pregnancy and during gestation. The negative influence provokes the birth of sick underweight babies who are not destined to wait for delivery on time.

Medical indications for the early birth of a baby include complex infectious diseases and inflammation in the genital organs, suffered throughout the entire life period. Often, the causes of premature birth are diseases of the thyroid gland, ovaries or endocrine glands.

Obesity is another factor that causes premature birth of a child. Injuries to the cervix after abortions, previous births or gynecological operations are considered the main culprits of the pathology.

Pros and cons of early childbirth

Expectant mothers, tired of a long period of gestation, dream of starting to give birth faster. Before making a decision to mechanically influence the duration of pregnancy, one should take into account the positive and negative aspects.

First, it is always a risk for the child. The fetus is born with a small weight and height, skin not fully formed, the nails do not completely cover the plate. In boys, the testicles do not have time to descend into the scrotum; in girls, the labia does not yet cover the small and clitoris.

The lungs of an infant do not always cope with the respiratory function, some children do not have a sucking reflex, so it becomes difficult to feed a newborn. Due to the fact that the bones of the skull of a premature baby are too soft, there is a possibility of brain injury during labor activity. Immunity in such children is weak, so they are susceptible to all diseases.

As for the advantages of premature delivery, it is an opportunity to get rid of discomforts such as heartburn, back pain, heaviness due to the weight of the baby. Premature birth can be a salvation for the mother and the baby for medical reasons.

Indications for early childbirth on the part of the woman in labor:

late severe preeclampsia;
premature abruption of the placenta;
too acute polyhydramnios the presence of a suture on the uterus, which is very overstretched

Child's condition:

photoplacental insufficiency;
Rhesus conflict;
prolonged fetal hypoxia;
delayed development of the baby 2 and 3 degrees.

In such situations, early childbirth will only help the woman in labor or her baby to alleviate their pathological condition. Here, the risks due to prematurity fade into the background, as there is a danger of death.

Folk ways

Women, in order to start giving birth faster, use advice from traditional medicine. This is dangerous, therefore, without good reason, manipulation is prohibited. Requires constant supervision of an obstetrician when applying stimulation of labor.

Is it possible to give birth before the due date? Quite possible. This requires not only the desire of the mother to get rid of the huge belly, but also medical indications. If there are none, it is better to give birth on time and not worry about the consequences.

There are also safe ways to bring the birth closer. You can use them, because the methods do not consist of medicines or herbs. This active life: hiking, walking on stairs and being in the fresh air. Physical activity not only fills the baby's body with oxygen, but also contributes to the onset of the birth process.

Sexual life is another natural labor stimulant. Orgasm smoothes the cervix and prepares it for childbirth, and sperm contributes to a faster opening of the organ. The position should be chosen comfortable for the expectant mother, and the regularity should be controlled. This method is applied until the moment of outflow amniotic fluid. If there are leaks of amniotic fluid, there is a possibility of infection of the fetus.

What to do to give birth earlier:

nipple massage;
enema;
use olive oil to soften the cervix.

Stimulation of the nipples will help tone the uterus, thereby pushing the body to the onset of labor. You need to perform the procedure three times a day for 15 minutes each breast. Often in maternity hospitals, bowel cleansing is used as a way to induce labor. The essence of the method is to provoke contraction of the uterus along with the walls of the intestine.

Some gynecologists recommend drinking or eating in a salad olive oil. The product is considered an emollient for the uterus and its cervix, stimulating bowel movements. It is enough to drink 100 grams of oil per day for the expected effect.

There is stimulation with herbal medicines, but it is not as safe as drinking olive oil. It is forbidden to mindlessly use herbs for pregnant women because of the negative effect on the fetus.

A decoction of raspberry leaves is used, which activates the muscles of the uterus and tones the pelvic organs. To prepare a decoction, take 2 tablespoons of dry red raspberry leaves and pour them with a liter of hot boiled water, then boil for a couple of minutes. Insist and drink 300-400 ml. in a day.

You can use homeopathic remedies (caulophyllum, pulsatilla). The drugs are absolutely harmless to the fetus and the pregnant woman, but not all obstetricians believe in their stimulating properties.

They resort to acupuncture, this method is rarely used in practice, but it has an effect on the onset of childbirth. It is believed that injections with needles in the right places contribute to the development of labor or intensification of contractions.

It is allowed to bring the date of birth closer only with the appointment of a doctor, as you can harm the baby and yourself. It is best to stay in a hospital during the use of stimulants.

Is it true that boys are born prematurely? No, it does not depend on the gender of the child. The state of health of the baby and mother, as well as the correctness of the dates set, are taken into account.

Medical impact

This method to bring delivery closer is used only for serious indications from the part of the woman in labor and the fetus. Everything must be carefully controlled.

When you need to help the development of childbirth:

at multiple pregnancy more than 37 weeks;
the presence of chronic diseases in the mother in the acute stage;
prolonged fetal hypoxia;
weakness of labor activity.

To quickly give birth in a hospital, radical stimulation options are used. Manipulations are carried out only under the supervision of an obstetrician or other medical staff, each body tolerates medications in different ways.

Childbirth calling methods:

puncture of the fetal bladder (amniotomy);
the use of prostaglandins;
the appointment of oxytocin;
taking mifepristone;
placement of a Foley catheter in the cervical canal;
use of laminaria.

Amniotomy, or puncture of the fetal bladder, is performed by inserting a special hook into the cervix. The bubble opens, the water leaves, and the baby's head begins to put more pressure on the small pelvis. This is how the development of labor activity is stimulated. This manipulation is completely painless, and is also safe for the baby when performed correctly.

Prostaglandins are used in obstetric practice for the rapid ripening of the cervix. It is clear that if you need to provoke childbirth a month ahead of schedule, this method is not very practical, because the whole body must prepare for childbirth.

There are several variations of prostaglandin release:

vaginal preparations;
tablets;
dropper solutions.

Vaginal agents are introduced into the anus. These can be gels, ointments or vaginal tablets. They are used every 6 hours, if necessary, repeat the procedure. Tablets for oral administration drink 0.5 mg every hour. After a while, the dose is increased by half. It is not recommended to use this method for more than two days. The solution for infusion is infused with a volume of 0.2 mcg / min, gradually increasing the dosage.

Mifepristone is actively used by obstetricians to give birth to a woman before term. It is prescribed according to the following scheme: 200 mg one-time. A day later, you can repeat the drug. The essence of the action of the stimulant is to block the production of progesterone, which provokes uterine contraction. The drug has a number of side effects.

Those who wish to give birth prematurely for medical reasons can try using a Foley catheter. It is used for premature maturation of the uterus. A special balloon is inserted into the neck and filled with a physiotherapy. This is how artificial stretching of the uterus and disclosure of the organ is achieved. The device is not removed for 12 hours. The method is suitable for giving birth on a certain date with a full-term pregnancy. This manipulation is painful for the woman in labor, but safe for the fetus.

Oxytocin is used to give birth early. It can be injections or droppers. There is no specific dosage for the administration of the drug, because the weight, age and condition of the woman in labor are taken into account. This is not a method for those who want to give birth 2 weeks ahead of schedule, since stimulation is appropriate when labor has begun or the uterus has partially opened.

Laminaria is pressed seaweed. The plant is injected into the cervix in the form of a tampon for premature disclosure. The tool helps to give birth earlier a week before the due date. Algae swell due to the humid environment and push the cervical canal apart.

It is possible to bring the birth closer, but it is advisable according to indications from the health of the mother or child. One desire to quickly see the baby should not be a reason to provoke the stimulation of delivery.

It is known that normal pregnancy lasts approximately 40 weeks. However, it often happens that the baby "does not live up" to the due date. Why do premature births occur, how do they proceed and why are they dangerous?

About terminology

Termination of pregnancy in the period of 28-37 weeks is called premature birth. Termination of pregnancy in the period from 22 weeks to 28 weeks, according to the rules of the World Health Organization, is classified as very early preterm birth. In our country, termination at this stage of pregnancy is not considered a premature birth, but at the same time, they provide assistance in a maternity hospital, and not in a gynecological hospital, and take measures to care for a deeply premature newborn. A child born as a result of such childbirth is considered a fetus for 7 days, only after a week such a baby is considered not a fetus, but a child. This feature of the terminology is due to the fact that children born before the 28th week of pregnancy are often unable to adapt to environmental conditions outside the womb, even with the help of doctors.

Causes of preterm birth

Factors leading to preterm birth can be divided into socio-biological and medical.

It should be noted that in the autumn and spring months the frequency of this complication increases. This is due to changing weather conditions, in particular the frequent change in atmospheric pressure, which can affect the frequency of premature rupture of amniotic fluid. Severe colds with a high rise in body temperature and a strong cough can increase and cause labor prematurely. An adverse effect on the course of pregnancy of a number of production factors was noted: exposure to chemicals, vibration, radiation, etc. Premature births are more common in young, unmarried, studying women, with a lack of protein and vitamins in food, as well as in women with bad habits.

Medical factors include severe infectious diseases, including those suffered in childhood, abortions, and inflammatory diseases of the genital organs. Chromosomal disorders of the fetus - damage to the hereditary apparatus of the fetus under the influence of adverse external and internal factors (ionizing radiation, occupational hazards, taking certain drugs, smoking, drinking alcohol, drugs, unfavorable environmental situation, etc.) - can lead to premature birth, but more often in In such cases, early termination of pregnancy occurs. In most cases, the cause of premature births are diseases of the endocrine system, such as dysfunction of the thyroid gland, adrenal glands and ovaries, obesity, in which the work of all endocrine glands changes. Anatomical changes in the genital organs include genital infantilism (underdevelopment of the female genital organs), malformations of the uterus, traumatic damage to the uterus during abortions and curettage, tumors of the uterus. In almost one third of cases, the cause of preterm birth is isthmic-cervical insufficiency, in which, as a result of mechanical influences (trauma of the cervix after abortion, previous childbirth, other gynecological manipulations) or a lack of certain hormones, the cervix does not perform its obturator function.

Often the cause of premature birth is cervico-vaginal infections (trichomoniasis, mycoplasma, chlamydia, etc.) and viral infections (cytomegalovirus, herpes, influenza, adenovirus infection, mumps), especially those that are hidden. The presence of a chronic genital infection contributes to the disruption of the local protective barrier and fetal injury. Severe forms of extragenital diseases (not associated with female genital organs) and pregnancy complications can also lead to preterm pregnancy. Such diseases include, for example, hypertension, cardiovascular diseases, anemia, chronic diseases of the lungs, kidneys, liver, etc.

Symptoms of the onset of labor

With the onset of preterm labor, regular labor activity and smoothing or opening of the cervix appear. The onset of labor activity is accompanied by the appearance of regular cramping pains in lower sections stomach, which increase in intensity over time, the intervals between contractions decrease. Quite often, premature birth begins with the outflow of amniotic fluid, and their amount can be from a few drops to several liters. In addition, the appearance of mucous discharge with streaks of blood or bloody discharge in a woman during a premature pregnancy indicates structural changes in the cervix, i.e. e. its smoothing. The appearance of any of the above symptoms requires urgent hospitalization in an obstetric hospital.

At the slightest suspicion of a deviation from the normal course of pregnancy, it is necessary to seek qualified help.

If these symptoms appear, you should immediately call an ambulance, which will deliver future mother to the hospital. In some cases, it is possible to prolong the pregnancy; if this is not possible, then conditions are created in the hospital for careful delivery - childbirth, during which a still very fragile baby experiences the least possible load.

Features of the course of childbirth

In preterm birth, premature rupture of amniotic fluid, weakness and dysfunction of labor, rapid or impaired regulatory mechanisms, fetal hypoxia are more often observed.

Premature rupture of amniotic fluid is more often manifested in isthmic-cervical insufficiency or the presence of infection. The lower pole becomes infected, and as a result of inflammation, the membranes are easily torn. Normally, the fetal bladder ruptures closer to the full opening of the cervix, that is, already with the development of labor. A woman's sensations can be different: from a small wet spot on her underwear to a large number water flowing from the vagina and flowing down the legs. The water should be clear, but can be cloudy and dark brown (in the presence of infection). Premature births very often proceed quickly or even rapidly. A woman has rather painful contractions, their frequency increases, the intervals between contractions are less than 5 minutes and quickly decrease to 1 minute, the first stage of labor (until the cervix is fully dilated) is reduced to 2-4 hours. Due to the fact that the head of a premature fetus is smaller, the expulsion of the fetus begins when the cervix is not fully opened. A smaller baby passes through the birth canal faster.

Premature baby

A child born as a result of premature birth has signs of prematurity, which are determined immediately after birth. The body weight of such a newborn is less than 2500 g, the height is less than 45 cm, there is a lot of cheese-like lubricant on the skin, the subcutaneous tissue is not sufficiently developed, the ears and nasal cartilages are soft. The nails do not go beyond the tips of the fingers, the umbilical ring is located closer to the bosom. In boys, the testicles are not lowered into the scrotum (this is determined by touch), in girls, the clitoris and labia minora are not covered by the labia majora, the cry is squeaky. It should be noted that the presence of one sign is not an indisputable proof of the prematurity of the child, the prematurity of the fetus is determined by the combination of signs.

Unlike timely births, there are more complications in preterm births. Firstly, the baby's head does not have time to adapt to the mother's pelvic bones and reconfigure. The configuration of the head is the possibility of displacement of the bones of the fetal skull during childbirth to reduce its volume when passing through the birth canal. This mechanism allows you to reduce pressure on the head and cervical spine of a newborn baby. The bones of the skull of a premature baby are rather soft and cannot provide protection for the brain, the risk of trauma, hemorrhages under the membranes in the brain tissue of the fetus during childbirth increases. As a result, the child may experience hemorrhages, he does not have time to adapt to changes in the environment, his regulatory system is disturbed. Secondly, often a woman gets ruptures of the birth canal (cervix, vagina and external genitalia), as the tissues do not have time to adapt to stretching.

With threatening and beginning childbirth, a woman is urgently hospitalized.

Much less often in preterm birth, weakness of labor activity occurs. Weakness can be manifested by weak, infrequent or short contractions. The time of childbirth increases significantly, the woman gets tired, the child also begins to suffer. Other anomalies of labor activity are possible, for example, the strength and frequency of contractions is sufficient, and the cervix does not dilate. All this is associated with a violation of regulatory systems in preterm birth, there is no sufficient hormonal preparation for childbirth. Infectious complications in childbirth and the postpartum period are much more common in both the mother and the fetus. Among these complications are suppuration of the sutures (if any), postpartum metroendometritis (inflammation of the mucous membrane and muscular layer of the uterus), peritonitis (inflammation of the peritoneum) and the maximum spread of infection (sepsis). This is due to the presence of a latent or overt infection that was present before childbirth in a pregnant woman, which is often the cause of miscarriage. Infection can join during childbirth, due to their duration (with weakness), for example, chorioamnionitis (inflammation of the membranes of the embryo). Premature babies have reduced immunity and, accordingly, are more susceptible to infections.

Prognosis for a child

Due to the peculiarities of obstetric tactics and the different outcome of childbirth for the fetus, it is considered appropriate to divide preterm birth into three periods, taking into account the timing of gestation (pregnancy): preterm birth at 22-27 weeks, preterm birth at 28-33 weeks, preterm birth at 34- 37 weeks of gestation.

Premature birth at 22-27 weeks (fetal weight from 500 to 1000 g) is most often caused by isthmic-cervical insufficiency (due to trauma in previous births), infection of the lower pole of the fetal bladder and premature rupture of the fetal bladder. Therefore, in this group of women, as a rule, there are few primigravidas. The presence of infection in the genital tract excludes the possibility of prolonging pregnancy in most pregnant women. The lungs of the fetus are immature, and it is not possible to accelerate their maturation by prescribing medications to the mother in a short period of time. Such children belong to the high-risk group and are more often subject to urgent resuscitation. They are in cuveuses, under the strict supervision of a neonatologist and qualified nurses. Children almost always need a further stage of nursing and are registered for a long time in perinatal centers or clinics at the place of residence.

Premature birth at a gestational age of 28-33 weeks (fetal weight 1000-1800 g) is due to more diverse causes than earlier preterm birth. There are more than 30% of primigravidas in this category of childbirth.

More than half of women carry out expectant management and maintain pregnancy. In such children, the lungs do not have time to "ripen", the production of surfactant is disrupted. Surfactant is a mixture of fats and proteins that is synthesized in the large alveoli (the building block of the lungs), coating them, promoting their expansion and preventing them from collapsing when inhaled. In the absence or deficiency of this substance, the child's breathing is disturbed. A surfactant preparation can be administered to neonates as needed and greatly facilitates breathing, but this preparation is very expensive and not readily available. Therefore, in order to prevent respiratory failure, women are prescribed glucocorticoids. They stimulate the production of surfactant and the "maturation" of the lungs in the fetus for 2-3 days with the threat of preterm birth. With the onset of labor, glucocorticoids are administered intravenously at intervals of 3-4 hours.

Preterm birth with a gestational age of 34-37 weeks (fetal weight 1900-2500 g or more) is due to even more diverse reasons, the percentage of infected women is much less than in the previous groups, and primigravida - more than 50%. However, due to the fact that the lungs of the fetus are almost mature, it is not necessary to administer drugs that stimulate the maturation of the surfactant.

Children are less likely to be transferred to the intensive care unit, but round-the-clock care and supervision are necessary in all cases until the child's condition is completely stabilized.

Nursing features

Premature babies, after examination by a neonatologist, are most often immediately transferred to the intensive care unit, and if necessary, to the intensive care unit. They are monitored around the clock, care and treatment, as well as prevention of possible complications. Premature babies have imperfect thermoregulation, they can be in an incubator, where temperature regime, humidity, oxygen levels, etc. They have a tendency to respiratory disorders, reduced resistance to environmental factors, so it is necessary to have round-the-clock duty not only of nursing staff, but also of a neonatologist. In most cases, premature babies, after certain efforts of a group of neonatologists, are transferred to the second stage of nursing in a specialized hospital. If there is a perinatal center in the city, the second stage of nursing is carried out in the same hospital where the birth took place, and the children are not transported. It should be noted that often premature babies stabilize rather quickly, and there is no need for a second stage of nursing.

Management of preterm labor

With threatening and beginning childbirth - when there is no cervical dilatation or it is insignificant - tactics are aimed at prolonging pregnancy. The woman is urgently hospitalized, strict bed rest is created, sedatives are prescribed, and the causes that led to premature birth are eliminated (if possible). For example, suturing of the cervix is performed for isthmic-cervical insufficiency, treatment of vaginal infections, restoration of the natural microflora of the vagina, or antibiotics in the presence of an infectious process, treatment is carried out in conjunction with a therapist or endocrinologist (if necessary). An obligatory component is drugs that reduce the tone of the uterus (tocolytics), improve the functioning of the placenta, increase immunity, vitamin therapy, as well as drugs that improve intrauterine nutrition of the child and accelerate the "maturation" of the lungs of the fetus.

In each case it is necessary individual approach However, the efforts of doctors do not always lead to the desired results, and the process goes into the onset of premature birth.

Round-the-clock care and supervision are necessary in all cases until the child's condition is completely stabilized.

Premature birth requires a qualified obstetrician-gynecologist, nurse and neonatologist. It is necessary to constantly monitor the woman and the condition of the fetus. A woman is regularly examined, pressure, body temperature are measured, urine and blood tests are monitored. In addition to data from cardiac monitoring, they control the development of labor, listen to the fetal heartbeat, and determine the position of the fetus. Fetal heart rate monitoring is a study of the heart rhythm. It is carried out on a special apparatus at rest, in the position of the pregnant woman on her side for 30-60 minutes. On the anterior abdominal wall of a pregnant woman, with the help of an elastic band, there are recording sensors that record the heartbeats of the fetus, as well as the frequency and strength of contractions.

Most of the complications in childbirth, both on the part of the mother and the fetus, are due to a violation of the contractile activity of the uterus. To identify the features of the contractile activity of the uterus in preterm labor, it is recommended to maintain a partogram (a graphical representation of the frequency and strength of contractions) and record the contractile activity of the uterus. A partogram can be carried out without any technique, by touch, with a stopwatch, to fix the frequency, strength and duration of contractions, and then depict them on a graph. However, all specialized centers have cardiomonitor monitoring, which clearly displays the condition of the child during the birth process, as well as the tone of the uterus and the effectiveness of contractions in dynamics, which allows timely adjustment and provision of qualified medical care in case of any deviations.

To determine the degree of cervical dilation, the doctor examines the woman on the gynecological chair. Due to the possible negative impact on the fetus, pacing or inhibition of labor is carefully considered, and often the issue needs to be resolved within a short time, with the decision being made by several doctors. Prevention of fetal hypoxia (lack of oxygen) is carried out; in most cases, narcotic painkillers are refused (since they adversely affect the fetal respiratory center). Childbirth is carried out in the supine position, because it is easier to control childbirth in this position, the head does not move quickly along the birth canal, the woman and fetus feel satisfactory, in contrast to the supine position, in which the pregnant uterus compresses large venous vessels, worsens maternal and fetal circulation. Pain and epidural anesthesia speed up the process of opening the cervix, which is often too fast. The fetal head does not have time to adapt to the birth canal, and often poorly extensible perineum exacerbates the situation, so they are approached individually.

It is in the power of the woman herself to reduce the likelihood of preterm birth. There is no need to hide previous abortions and inflammatory processes in the past from the doctor with whom the woman is registered. It is necessary to immediately inform the doctor about all changes in your body, go to special classes in preparation for childbirth. When a pathology is detected, one should not refuse the treatment prescribed by the doctor. Need to limit physical exercise, follow the diet, which should be varied and well balanced. Excessive consumption of spicy, salty or fatty foods leads to exacerbations of chronic diseases digestive system that can cause premature birth. If symptoms of pregnancy appear, sexual activity should be avoided during the last two months of pregnancy. If there is the slightest suspicion of a deviation from the normal course of pregnancy, it is necessary to seek qualified help.

Nadezhda Egorova,
obstetrician-gynecologist, assistant of the department of obstetrics and gynecology,
Astrakhan State Medical Academy, Astrakhan

Text: Alena Kuznetsova

As one therapist told me, "pregnancy is a crazy journey into the unknown." Now, when I have my own and a thousand other people's stories heard in the maternity wards, I agree with him. Yes, pregnancy is like Russian roulette. I know those who successfully gave birth at home in the bathroom or said that going to the dentist is scarier. I also know those who lay in storage for months, experienced miscarriages and clinical death. My lottery ticket said I was to give birth two months early.

Everything was unexpected and did not fit into my picture of an “ideal” pregnancy and childbirth at all.

My pregnancy wasn't perfect, but I loved it. A slight malaise in the first trimester, but an unprecedented rise in strength in the second. The doctor in the antenatal clinic is always friendly and satisfied. I didn’t get sick, I took the prescribed vitamins and tried to walk more often. Closer to the third trimester, the fear of childbirth intervened in my euphoria, and I enrolled in a school for pregnant women. In one of the classes, they said that one in four of us will give birth with the help of caesarean section. I didn’t take it seriously: I’m in excellent health, my birth will be natural, like my mother’s. The main thing is how to tune in.

When it was the 31st week of my pregnancy, I sat in the chat of the school of cultural journalism, where I entered as a free student. I was waiting for a discussion of my work and suddenly felt that my stomach became very hard, and the baby's tremors became more palpable. It seemed to me abnormal - I called the doctor from the consultation, and she ordered to call an ambulance or do an ultrasound at the nearest gynecologist. The situation did not look serious, so I chose the second one: just in case, I put the documents that I needed to enter the maternity hospital in my backpack and got into a taxi.

The doctor listened to the complaints and habitually opened the tonometer, from which I did not expect anything bad. It turned out that the pressure was 170/120, although it was not felt at all. An examination in a chair, an ultrasound, some kind of recording in the direction and the first injection of magnesia, which many pregnant women know: it effectively relieves the tone of the uterus, and it feels like a poison that slowly paralyzes the entire leg. "Real fighter!" my sister said after I didn't make a sound. I looked at the paper with the referral, and finally the diagnosis reached me: the threat of premature birth. Still needed an ambulance.

I remembered what I had read in the weekly maternity mailing list: "Baby has grown a lot and is now developing lungs." It turns out that he is not yet at all ready for birth - he has not gained enough weight, strength, his organs are still being formed with might and main. Will he be able to live at all if he is born? I had never heard of those who gave birth prematurely, and had no idea if it was bad. Everything was too unexpected and did not fit into my picture of an “ideal” pregnancy and childbirth at all. The arriving brigade reassured me: everyone writes like that, it’s not worth crying - otherwise the pressure will still rise.

We were planning paid family births, but we had not yet managed to conclude an agreement and even choose a maternity hospital - so I was taken to the nearest one. There was another injection of magnesia in the emergency room, as the pressure did not drop. I did not believe that something serious could happen to me: I was worried, scared, the doctors were playing it safe. Tomorrow they will go home.

If the birth occurs before the 37th week of pregnancy, then, according to the definition of the World Health Organization (WHO), the child is considered prematurely born and premature.

The term "prematurity" also means that the child is born before the due date of intrauterine development and underdeveloped.

The weight of premature babies usually ranges from one and a half to two and a half kilograms. The modern level of medicine allows such children not only to survive, but also fully develop .

However, some time must pass before such babies begin to feed on their own and can leave the maternity hospital.

Degrees of prematurity and consequences

Are all premature babies born prematurely?

Not all low weight babies are born before 37 weeks. Some of them failed to gain enough weight during pregnancy.

Experts believe that with the same degree of readiness of the baby's body for independent existence normal weight at birth - always an advantage.

placental insufficiency

One of the causes of low birth weight is placental insufficiency, in which the placenta ceases to function normally. Because of this, the fetus does not receive enough nutrients for normal growth.

Placental insufficiency occurs with complications of pregnancy, for example, with gestational diabetes - a violation of glucose metabolism caused by improper nutrition of a pregnant woman.

If mom smokes

An equally serious cause of growth retardation in a child is maternal smoking. Number of cigarettes smoked during pregnancy baby growth slows down to varying degrees. In pregnant women who smoke daily, the risk of having a baby weighing less than 2500 g is doubled.

Other reasons

Other causes of low birth weight are malformations and chromosomal abnormalities in the child. Most of them are detected during screening, carried out in the second trimester of pregnancy.

Also, various infectious diseases that affect both the mother's body and the child during fetal development lead to low birth weight.

Why are babies born prematurely?

Despite numerous studies, scientists still cannot say with certainty what triggers the birth process.

In recent years, the most popular theory among specialists is that the child's body independently determines the optimal time for childbirth. The pituitary gland of the child is presumably responsible for this mechanism.

The causes of preterm birth, on the other hand, are well known.

stress

Often, early childbirth causes stress and hard physical work. Thus, the results of studies show that the death of close relatives, job loss or divorce can lead to premature birth.

infections

Also, premature birth can be triggered by an infection of the urinary and genital tract of a woman. Experts believe that the bacteria secrete chemicals that cause uterine contractions.

Often these diseases are asymptomatic, and a woman may not know she is ill. The risk of preterm birth can be reduced by identifying and treating the infection before or early in pregnancy. Currently, there are a sufficient number of drugs that do not harm the baby.

Weakness of the cervix

In about 20 percent of preterm births, cervical weakness is the cause. This disorder is easy to detect during pregnancy if you visit a doctor regularly. The weakness of the cervix is eliminated by strengthening the tissues with a surgical thread.

Other reasons

In addition, preterm labor often begins with multiple pregnancies, uterine bleeding of various origins, high blood pressure and pregnancy complications.

Also, according to some reports, the tendency to early childbirth can be inherited. Mothers who were born prematurely are more likely to have preterm births.

The most important

A premature baby can be born prematurely due to stress or illness of the mother. However, the birth of an underdeveloped child can also be provoked by the mother herself if she smokes during pregnancy, eats unhealthy food and neglects frequent visits to the doctor during the entire period.