It is defined as labor occurring before

compeletion of 37th weeks of pregnancy

counting from last menstrual period.
 History.
 Complications in prevoius pregnancy.
- Maternal.
- Fetal.
- Placental.
- Idiopathic.
 Presentation of the woman.
 Regular or frequent contractions — a tightening
sensation in the abdomen
 Constant low, dull backache
 A sensation of pelvic or lower abdominal pressure
 Mild abdominal cramps
 Diarrhea
 Vaginal spotting or bleeding
 Watery vaginal discharge (water breaking) — in a gush or
a trickle
 A change in vaginal discharge.
 Full blood count.
 Urine for routine analysis.
 Endocervical swab for any causative organisms.
 Ultrasonography.
 Serum electrolyte and glucose level ( when tocolytic
agents are used ).
 Low birth weight
 Breathing difficulties
 Underdeveloped organs
 Vision problems.
 Children who are born prematurely also have a higher
risk of learning disabilities.
 Identifications of risk factors.
 Premature effacement of cervix
 Close observation
 Confirming the gestational age
  The principles in the management of preterm labor are –

1. To Prevent asphyxia.

2. To prevent birth trauma.

 Bed rest.

 Oxygen administration by mask.

 Monitor progress of labor.

 Gentle and slow delivery.

 Episiotomy.

 Immediate cord clamping.

 Baby under observation of neonatalogist.

Spontaneous rupture of membranes any time
beyond 28th week of pregnancy
 Idiopathic.
 Increase friability of membranes.
 Decrease tensile strength of membranes.
 Polyhydarmnios.
 Multiple pregnancy.
 Cervical incompetence.
 Infection.
 Painless gush of fluid that leaks out of the vagina.
Sometimes women notice a steady leakage of small
amounts of watery fluid.
 Other symptoms include -
Change in color and consistency of fluid.
Flecks of meconium in the fluid.
Decrease in the size of the uterus.
 The WHO defines fetal death as death prior to complete
expulsion or extraction from the mother, regardless of the
duration of pregnancy.
  Pregnancy complications
1. Pre-eclampsia.
2. Antepartum hemorrhage.
 Pre-existing medical diseases.
1. Chronic hypertension
2. Diabetes
3. Chronic nephritis
4. Syphilis
5. Hyperpyrexia
6. Severe anemia
 Fetal causes
1. Congenital malformation.
2. Rh-incompatibility.
3. Postmaturity.
 Latrogenic.
 Idiopathic
 Absence of fetal movements.

 Diminished uterine tone.

 Retogression of breast.

 Gradual Retogression of height of uterus.

 Eggshell cracking of fetal head.

 Ultrasonography.

 X – ray.
 Extreme psychological upset of the woman

 Infection

 Blood coagulation disorder.

 During labor
 Prenatal care and monitoring.

 Screening the “ at risk mother’’.