By Dr Joe Kabyemela, MD
Preterm labour, also called premature labour, is a fairly common pregnancy complication. Sometimes there are identifiable causes but, in most cases, the trigger remains a mystery. A small minority of women are prone to preterm labour and therefore will tend to have it as a recurrent phenomenon. For most, however, it is a one-off.
There are a great deal of false alarms and some studies have estimated that, in up to 80 per cent of instances, there is really nothing significant going on. However, it is absolutely imperative that any uterine activity occurring before term is investigated. It is also crucial that any such suspicion is reported promptly because, if it turns out to be true preterm labour, time is a critical factor in the eventual outcome. In this case, quite literally, "every minute counts". We shall see why this is so, in the following section.
A few myths need to be exploded up-front. There is no such thing as an effective treatment for preterm labour. The best on offer can only curtail labour for hours, at most. If perceived "contractions" stop after some form of "treatment" and do not recur again, there is strong evidence that this simply means they would have stopped without the treatment anyway.
Another myth is that inactivity in the form of bed rest may arrest preterm labour. There is no evidence that this is ever the case.
There are claims appearing in the popular press from time to time that, as early as twenty-two weeks or even earlier, the baby should survive, if given the maximum benefit of modern medical technology. This is a cruel hoax perpetuated by sensationalist, mostly down-market journalists.
Any expert or caregiver who spends his or her life in the highly charged and very intense atmosphere of a special care baby unit will tell you that, for every perceived triumph of a healthy baby painstakingly retrieved from the jaws of severe prematurity, there are dozens who never make it or survive with profoundly severe cerebral palsy.
However, it is fair to state that the care of prematurely born babies has advanced so much over the years, that prospects for these children are, in modern times, infinitely better than only a few years ago. The degree of prematurity is, however, still a critical factor.