What Is Preterm Labour?
Labour that begins before 37 completed weeks of pregnancy is considered preterm. Babies born before 37 weeks — and particularly before 34 weeks — face a higher risk of breathing difficulties, feeding problems, infection, and long-term developmental challenges. Prevention and early management are critical.
Risk Factors for Preterm Labour
- Previous preterm birth — the single strongest predictor
- Short cervix detected on mid-trimester ultrasound
- Multiple pregnancy (twins, triplets)
- Uterine abnormalities — bicornuate uterus, fibroids
- Cervical incompetence — previous cervical procedures (LLETZ, cone biopsy)
- Infections — bacterial vaginosis, urinary tract infections
- Placental complications — placenta previa, abruption
- Smoking, substance use, nutritional deficiency
- High maternal stress and poor social support
Prevention Strategies
- Cervical length monitoring — transvaginal ultrasound at 16–24 weeks to identify short cervix before symptoms develop
- Cervical cerclage — a suture placed in the cervix to provide mechanical support in women with cervical incompetence
- Progesterone supplementation — vaginal or intramuscular progesterone reduces preterm birth risk in women with short cervix or previous preterm birth
- Infection screening and treatment
- Lifestyle modification — rest, hydration, smoking cessation
Management of Acute Preterm Labour
- Tocolysis — medications to temporarily pause or slow contractions
- Corticosteroids — to accelerate fetal lung maturity before 34 weeks
- Magnesium sulphate — for fetal neuroprotection before 32 weeks
- Neonatal team coordination — ensuring specialist newborn care is ready at delivery