Premature birth, threatened miscarriage

Authors of the article: Candidate of Medical Sciences O.Yu. Ermolaev

Obstetrician-gynecologist, specialist in proper nutrition during pregnancy E.K. Ermolaeva

Preterm birth is birth between 22 and 37 weeks of pregnancy.

Premature birth is one of the most common causes of childhood death and illness today.

Premature babies are often weakened, they may have breathing problems (in some cases, respiratory arrest), problems with feeding and maintaining body temperature.

In premature babies, diseases of the respiratory system and gastrointestinal tract occur more often and recur (recur many times), and mental or physical disabilities are more often identified.

The above personal family and social problems determine the importance of taking the threat of miscarriage and premature birth seriously.

• What is premature birth, threat of miscarriage?
• Why do they arise?
• What to do?
• Why lie down?
• What will happen if you don't lie down?
• How does the child feel? Is he hurt?
• Symptoms (signs) of threatened miscarriage, threatened premature birth
• Signs of ruptured membranes
• What to do if the membranes rupture?

Conditions in which there is a risk for a successful pregnancy are given the COMMON NAME “threat of miscarriage” or “THREAT of premature birth”.

The term “threatened miscarriage” is usually used when the pregnancy is less than 22 weeks.

The term “threat of preterm birth” is used between 22 and 37 weeks of pregnancy.

Causes of premature birth

1. The cause of premature birth and the threat of miscarriage is psycho-emotional STRESS of the pregnant woman and/or fetus, FEAR.
2. A common cause of premature birth and threatened miscarriage is inadequate physical activity (physical stress). Pregnancy is NOT THE TIME for RECORDS! Long walking (more than 20 minutes continuously), running, jumping, long jump, jumping rope, extreme sports, carrying bags, buckets, lifting and carrying a child and objects weighing more than 3 kg are not advisable. NOT DESIRED during pregnancy participation in general cleaning, performing work with a bent torso and “squatting”, long-term (more than 20 minutes continuously) standing.
3. The cause of premature birth and the threat of miscarriage in the early stages of pregnancy is placental or decidual (due to abruption of the placenta or mucous membrane of the uterine cavity) BLEEDING.
4. A serious cause of premature birth and the threat of miscarriage in early pregnancy is INFLAMMATION in the decidual tissue (endometritis during pregnancy), amnionitis (inflammatory reaction in the amniotic fluid), chorionitis (inflammation of the fetal membrane, “fetal membrane”).
5. One of the causes of premature birth (birth before term) is wearing shoes with HEELS more than 3 cm. Wearing high-heeled shoes changes the angle of the pelvis, making the gait unstable. Unsteady gait is compensated by increased tone (compensatory tension) of the muscles of the back, legs, abdomen and uterus! The pregnant uterus actively participates in balancing the torso!
6. The cause of premature birth and the threat of termination of pregnancy can be a SHARP movement, getting up from a chair, or falling. A sharp change in body position causes a protective tone - protective tension of the uterus.
7. HOT WEATHER. According to statistics, the threat of miscarriage and premature birth (birth before term) are significantly more likely to occur in hot weather due to changes in vascular tone.

Pancreatitis

This is a disease that is inflammation in the pancreas. There are quite a few reasons for this. Most often these are errors in nutrition. Fortunately, among expectant mothers the incidence rate is low, because they carefully monitor their diet. But it is with pancreatitis that the back hurts at the 15th week of pregnancy and even earlier.

The development of this disease will be facilitated by a violation of the outflow of bile. And a growing fetus often leads to malfunctions of internal organs. In severe cases, you may notice that the facial skin of the expectant mother acquires a yellowish tint. Reasons include stress and hereditary predisposition. Add to this a violation of the diet, the predominance of fatty and heavy foods, and you get the full bouquet necessary for the development of pancreatitis.

In the acute phase of the disease, the lower back ache. The 15th week of pregnancy is the period when the threat of miscarriage is over, but you still need to be careful about such symptoms. The pain often becomes girdling, and soon it will be difficult for a woman to describe exactly where it hurts. In severe cases, this is accompanied by vomiting, stool disturbances, and low blood pressure. Don't waste time, you need to go to the hospital urgently.

Timing of the threat of pregnancy, timing of the threat of miscarriage

The threat of miscarriage most often occurs during

5-6 weeks of pregnancy 7-8 weeks of pregnancy 10-12 weeks of pregnancy 15-16 weeks of pregnancy 20-21 weeks of pregnancy 24-25 weeks of pregnancy 26-28 weeks of pregnancy 30-31 weeks of pregnancy 32-34 weeks of pregnancy

During these periods of pregnancy, PHYSIOLOGICALLY (provided for by the natural characteristics of human physiology), the tone of the uterus increases significantly and there is a threat of miscarriage, the threat of termination of pregnancy, and the threat of premature birth.

Action of doctors

To find out why the lower back hurts at the 15th week of pregnancy, you often have to undergo a number of laboratory tests. This is necessarily urine and blood. In addition, it is necessary to undergo an ultrasound and MRI. The rest of the examination depends on the specialist’s observations and what other diseases he wants to exclude.

If pancreatitis is diagnosed, treatment is usually carried out in a hospital. In this case, a strict diet and a number of medications are prescribed that should normalize the activity of the pancreas. The choice of medicines is quite large, so we will not list their names. Let's leave the privilege to the doctor. Additionally, painkillers and anti-inflammatory drugs are selected. In some cases, these may be special antibiotics.

Why is it necessary to lie down when there is a threat of miscarriage or a threat of premature birth?

The uterus is a muscular organ consisting of multidirectional muscle fibers that make up a single muscle.

Thus, the cervix and the body of the uterus are a single muscle. A protective increase in tone (PROTECTIVE SPAS) of the cervix protects the uterus from opening and at the same time, due to the painful sensation, ALLOWS a woman to RECOGNIZE the wrongness of the actions she has committed (or is performing).

The HORIZONTAL POSITION can significantly reduce the load on the cervix and, in most cases, contributes to the natural normalization of uterine tone.

Taking medications aimed at reducing the tone of the uterus has a similar effect.

However, when moving to a vertical position, the cervix, relaxed by the drug, cannot fully perform the retaining function!

THE RISK OF MISCARRIOR (premature birth) when the body is in an upright position while taking medications that relax the uterus increases sharply.

JUST LIE! And strictly follow your doctor’s recommendations!

A protective INCREASE in the TONE of the uterus is a natural PROTECTIVE REACTION aimed at preserving the offspring. You need to LIE!

How to help yourself?

It is quite possible to cope with such pain if you follow simple rules. You need to eat a varied diet. First of all, foods rich in calcium will help. These are milk, fish, nuts, herbs and meat. If pain bothers you constantly, then discuss with your doctor the option of taking a course of calcium tablets.

• It is necessary to limit movements that increase stress on the back.
• To pick something up from the floor, you need to crouch down, rather than trying to bend over.
• Try to sit down smoothly, redistributing your weight.
• And, of course, an orthopedic mattress is best for sleeping. Take an anatomical pillow; it follows the curves of the spine and allows you to reduce the load on it.
• Buy comfortable shoes with low heels.

These are preventive measures that can protect you from discomfort and give you a happy pregnancy.

How does a baby feel when there is a threat of premature birth?

We can only guess the answer to this question based on physiological data.

A pregnant woman and her fetus share a common circulatory system. Stress hormones (cortisol, adrenaline, prolactin), entering the general bloodstream, cause certain reactions from the central nervous system (brain and spinal cord), muscular system and other organs and systems.

If a pregnant woman is scared, experiencing pain, uncertainty about the future, her heartbeat and breathing become more frequent. The child may experience similar emotions and physiological reactions: FEAR, pain, tachycardia (rapid HEARTBEAT).

Increased uterine tone fixes the fetus and LIMITS its freedom of movement. Restriction of freedom of movement can cause some discomfort in the fetus.

Should pregnant women enroll in courses for expectant mothers?

“Communication is in any case a source of positivity, so such courses will certainly be good for expectant mothers,” says Maria Prokhorova. — At them, at a minimum, you will meet women who can share with you any emotions and sensations associated with the magical state of pregnancy. In addition, by attending such courses, you will be able to dispel all your fears regarding the course of pregnancy and future childbirth, since most common issues will be addressed during these meetings.”

Symptoms of threatened miscarriage, signs of premature birth:

A pregnant woman and her husband MUST KNOW the symptoms of threatened miscarriage and signs of premature birth!

1. A symptom of a threatened miscarriage and a sign of premature birth is a dull, ACHING PAIN in the lumbar spine (LOWER). The pain does not stop (does not disappear) spontaneously (spontaneously) within 10 MINUTES or intensifies.
2. A symptom of a threatened miscarriage and a sign of premature birth is aching pain in the lower abdomen, AS WITH MENSTRUATION.
3. A symptom of a threatened miscarriage and a sign of premature labor are cramps (CONTRACTS) in the lower abdomen. Spasms (contractions) in the lower abdomen can be of varying strength and duration in primiparous and multiparous women. The feeling of pain is also very subjective and depends on the moral readiness for childbirth, the contractility of the uterus, the content of microelements in the woman’s body (in particular, calcium, potassium, magnesium and phosphorus), etc. IMPORTANT that when there is a threat of premature birth, the STRENGTH of contractions DO NOT weaken (do not change) or increase; The DURATION (time) of the contraction DOES NOT SHORTEN (does not change) or increase; and the frequency of contractions does not change or increases.
4. A sign of premature birth is PRESSURE in the VAGINA, the sensation of a foreign body, something preventing you from walking.
5. A sign of premature birth is a feeling of the urge to defecate, pressure on the rectum with the desire to empty the intestines.
6. A sign of premature labor is the appearance of thin, clear vaginal discharge.
7. A sign of premature birth is the expulsion of a mucous plug, amniotic fluid, or the appearance of pink (scarlet) discharge from the genital tract before 38 weeks of pregnancy.

Every healthy pregnant woman, starting from 32 weeks of pregnancy, may periodically experience short-term, cramping, mild PAIN (the uterus “comes to tone”).

Short-term pain (harbingers of labor) is associated with the preparation of the uterus for childbirth - “working out the interaction” of muscles and nerve receptors (nerve endings).

But if the pain is aching or cramping in nature or occurs more often than 4-5 times within an hour, you are probably going into labor. In some cases, prenatal contractions may not be accompanied by pain.

If you think you're going into labor, don't panic, lie on your left side and COUNT THE NUMBER OF CONTRACTIONS. If you experience 5 or more contractions within an hour, CALL your doctor.

If you begin to leak clear water or other fluid from your genital tract, TELL your doctor. The doctor will tell you what to do next.

Perhaps you have increased uterine tone.

There may be individual characteristics of your pregnancy.

In this case, the doctor will advise you to LIMIT physical activity, temporarily abstain from sexual intercourse, REST more, limit productive activity or stop working, visit the doctor more often and, possibly, prescribe medications that reduce the tone of the uterus and normalize the state of the nervous system.

It is important to call or visit your doctor PROMPTLY if you experience these symptoms.

Consulting an obstetrician-gynecologist will REDUCE the RISK of premature birth.

There are no two women who gave birth the same way, just as there are no two identical births for the same woman.

Don’t take everything that other women tell you about their personal experience as absolute truth and instructions to follow.

ASK your obstetrician-gynecologist any QUESTIONS you are interested in. You will receive an objective, competent answer based on the observations and experience of generations of obstetricians and gynecologists.

We are AT YOUR FULL DISPOSAL if you have any doubts or wishes.

Exacerbation

The situation is much worse if neurological diseases become the cause of concern. There are a huge number of them. These are radiculitis, intervertebral disc herniation, protrusion and much more. Moreover, often the expectant mother does not even know about it. If she led a healthy lifestyle, did gymnastics and did not allow excessive stress on the lower back, then the disease could become latent. But carrying a baby affects your health, so at the 15th week of pregnancy, lower back pain can make itself felt. Moreover, they are often very intense.

In this case, self-medication is unacceptable. It is important to go to the hospital on time. The doctor will recommend bed rest to the patient and will also select a soft corset. In some cases, painkillers are prescribed. But this is rather the exception than the rule. Of course, the choice here is up to the specialist who is managing the pregnancy.

Leading specialists in the management of complex pregnancies in the Southern Federal District

Ermolaeva Elvira Kadirovna is a well-known and recognized specialist in the North Caucasus in the field of diagnosis and treatment of miscarriage, miscarriage, recurrent miscarriage, management of pregnant women with thrombophilia, antiphospholipid syndrome (APS), systemic lupus erythematosus (SLE), uterine fibroids, management of pregnancy in young and older pregnant women (after 38 years), management of capricious pregnant women, management of pregnant women with excess body weight. A good obstetrician-gynecologist, a specialist in rational nutrition during pregnancy, a physiotherapist-resortologist, an experienced ultrasound doctor. Those who want to maintain their figure and successfully carry woman's pregnancy.

Ermolaev Oleg Yurievich Candidate of Medical Sciences, gynecologist-endocrinologist with 25 years of experience and successful experience in managing pregnancy in women with uterine prolapse, bicornuate uterus, saddle uterus and other malformations of the genital organs, managing pregnant women with livedo, thrombophilia and antiphospholipid syndrome (APS) , polycystic ovary syndrome. Management of multiple pregnancies, which require special attention and experience from doctors. Management of pregnancy after IVF, ICSI, after artificial insemination. Management of pregnant women with placental insufficiency. Management of pregnancy against the background of an IUD.

About the doctors of the Clinic in detail...

INTERNATIONAL RECOGNITION of the reputation and achievements of the Women's Health Resort Clinic in the development and implementation of effective and safe treatment methods and the quality of medical services provided is the AWARDING of the Women's Health Resort Clinic in Pyatigorsk with the SIQS International QUALITY CERTIFICATE in the field of medicine and healthcare. International Socratic Committee, Oxford, UK and Swiss Institute for Quality Standards, Zurich, SWITZERLAND. Read more…

Diagnosis and treatment

Usually, kidney problems are the first thing a doctor thinks about when lower back pain occurs at 15 weeks of pregnancy. Why this happens needs to be clarified using modern diagnostic tools. To determine the diagnosis, the doctor sends the patient for an ultrasound. Additionally, laboratory tests of urine and blood will be required.

If the diagnosis is confirmed, then first of all it is necessary to culture the sensitivity of the microflora. That is, to find out the reason that caused the inflammatory process. Based on this, the specialist will select antibiotics. Treatment can be carried out on an outpatient basis; this is usually where they begin if the lower back and abdomen hurt at 15 weeks of pregnancy.

Reviews from doctors, however, claim that inpatient treatment will be more effective. The expectant mother will not have to run to hospitals and stand in queues. Therefore, if the pain is severe, then the issue is resolved unambiguously. The woman receives a certificate and is given a referral for hospitalization.

For renal colic, antispasmodics and painkillers are used. At the same time, it is necessary to prepare a program for the prevention of new inflammations. This could be a course of immunomodulators, recommendations for visiting a swimming pool or another health group. Such measures cannot be called therapeutic in the full sense, but they greatly help speed up recovery and avoid a new exacerbation. And if a specialist has determined a course of therapeutic and rehabilitation therapy for you, then you cannot deviate from it.

Signs of ruptured membranes

The amniotic sac may rupture (rupture) in the CENTER just above the cervix. In the event of a central rupture of the amniotic sac, the amniotic fluid will come out in a hot stream (“gushing out like a bucket”), the waters will break.

In some cases, rupture of the membranes occurs above the internal os (opening) of the cervical canal. In the case of a high lateral rupture of the membranes, a SIGN OF RUPTURE of the membranes is the leakage of amniotic fluid in small portions (water leakage).

Often a pregnant woman feels that the pad or underwear has become wet, but cannot understand the reason - it is heavy discharge or rupture of water, leakage of amniotic fluid.

Increased vaginal discharge when coughing (“COUGH TEST”) is a sign of high rupture of the membranes and leakage of amniotic fluid.

General recommendations for the expectant mother at 15 weeks

“Keep a sleep and rest schedule, go to bed on time, don’t overload yourself, try to wear clothes made from more comfortable and natural materials, and, of course, stick to a healthy, balanced diet,” advises Maria Prokhorova. - If you continue to play sports during this period, it should still be moderate exercise. In an effort to maintain an attractive figure and muscle corset, please do not overdo it in the gym. Have an easy and comfortable pregnancy!”

What to do if the membranes rupture?

RUPTURE of the amniotic sac always occurs unexpectedly and WITHOUT PAIN.

If amniotic fluid leaks or is suspected of leaking, you should NOTE THE TIME of the incident (“note the time”), PLACE a clean SHEET between your legs, take a horizontal position (LIE) and CALL your doctor.

If it is impossible to discuss the situation with your doctor, you should immediately CALL an ambulance.

This algorithm of actions in case of rupture of membranes is the only correct one, since after 12 hours the probability (risk) of infection of the fetus and the pregnant woman increases significantly, and the need arises to resolve the issue of the method of delivery (birth).

Considering that RUPTURE of the amniotic sac always occurs UNEXPECTEDLY, a pregnant woman must constantly CARRY with her an outpatient (exchange) card, a copy of her passport, and an insurance policy. YOU CAN have electronic COPIES of your exchange card, passport, insurance policy in your PHONE.

CHECK that your doctor's telephone number, obstetric hospital telephone number and emergency medical service telephone number are available in your phone book (in your phone).

If a critical situation arises, DO NOT rely only on yourself - LOUDLY, thinking about the child and WITHOUT HESITATION, seek help from others, warning about your pregnancy.

Starting from 24 weeks of pregnancy, it is very wise to form an “ALARM SUITCASE”. A complete list of things for the maternity hospital in detail...

The threat of miscarriage, the threat of premature birth, rupture of amniotic fluid are contraindications to driving: call an ambulance, DO NOT RISK the health of the baby, your life and the well-being of your family!

A familiar problem

This is what most mothers will answer. Indeed, few people carried the baby and never experienced back pain. There are also such statistics. The younger the mother, the less she experiences such discomfort. Especially if this is her first baby. By the time a woman dares to go for the second one, age has already taken its toll.

Still, let's try to understand the general reasons why the lower back hurts at 15 weeks of pregnancy. This will not replace consultation with a doctor, but will provide certain guidelines for the woman herself. Everyone knows that during this period the body of the expectant mother works under increased load. This ensures the normal development of the child.

Of course, one cannot equate the concepts of load and pain. But in such conditions, all the weak points in the woman’s health make themselves felt. If there are problems with ligaments, the spine, injuries, then all this will affect your well-being. As the fetus grows, the center of gravity of the woman's body shifts. As a result, we are faced with lower back pain at the 15th week of pregnancy. Let's figure out how to help your body cope with all the difficulties of this difficult path.

When to go to the maternity hospital?

• if your water starts to break;
• if you start BLEEDING;
• if you have CONTRACTS every 6-8 minutes.

Doctors and midwives of the Women's Health Resort Clinic are always ready for pregnant women registered for pregnancy in our Clinic, if it is impossible to contact them in person, to comment remotely (by phone, Internet) on an existing or newly emerging situation.

We are at your FULL DISPOSAL if you have any doubts or wishes.

Subsections

• Pregnancy management
• Cost of pregnancy counseling
• Screening during pregnancy
• Examination of pregnant women for congenital malformations of the fetus
• Comprehensive assessment of pregnancy markers
• Ultrasound of pregnancy
• Development of pregnancy by week
• Critical periods of embryonic development
• Possible problems during pregnancy
• Proper nutrition during pregnancy
• Hygiene for a pregnant woman
• Sleeping during pregnancy
• Risk factors (caution for pregnant women)
• Determining acceptable weight gain during pregnancy
• Determining your child's date of birth
• Assessment of fetal movement activity
• Sexual life during pregnancy
• Breathing and relaxation techniques during childbirth
• Literature for preparing for childbirth and raising children
• Premature birth, threatened miscarriage
• The first days after childbirth
• Program No. 7. Postpartum rehabilitation and VUM-building
• Program No. 16. How to remove belly fat
• Breastfeeding or bottle feeding?
• Breastfeeding: problems and rules
• Swaddling a baby
• Let's go to the maternity hospital! Things for mom and baby
• Measuring basal temperature and maintaining a graph
• Teeth and pregnancy
• Our mothers
• School of Natural Motherhood
• Questions and answers about pregnancy
• Reviews about pregnancy management in our Clinic

Natural Change

The healthier the expectant mother, the less likely she is to encounter such problems. Therefore, watch the condition of your back. Go to the gym and swim, get massages regularly. Such preparation for motherhood will give you a good chance to get through the next nine months easier.

The pregnancy period has a certain effect on the femoral-sacral joints. If previously they were motionless, today everything is changing rapidly. And this is one of the main reasons why the lower back hurts at the 15th week of pregnancy. Under the influence of hormones, the ligaments on these joints begin to relax. This is necessary in order to facilitate the passage of the baby during childbirth.

But it is relaxation, combined with the growing size and heaviness of the abdomen, that leads to imbalance. To relieve tension, a woman has to bend her neck and pull her shoulders back. But as a result, the stomach only protrudes forward more. This makes the problem worse. The spine arches, the muscles of the lower back are constantly tense, as a result the pain becomes stronger day by day.