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Preterm Labor and Birth

Preterm Labor and Birth

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If your health-care provider determines that you are in preterm labor, you may be admitted to the hospital. You'll probably be given intravenous fluids (through a needle in your arm). The most common medications used to stop or slow labor contractions are magnesium sulfate, ritodrine (the only FDA approved medication for premature labor) and terbutaline. A number of other medications are still being investigated for this use, including prostaglandin synthetase inhibitors (indomethacin), calcium-channel blockers, aminophylline and progesterone. You are often given an antibiotic prophylactically, even if you have no obvious infection. Also, you'll usually be given steroid medications to speed up your baby's lung development.

If your contractions are successfully stopped, you may be sent home from the hospital, sometimes with an oral medication. You'll probably be asked to decrease your activity level, or even to stay on bedrest, until you get closer to your due date.

Sometimes when you are in premature labor, your doctor may choose to allow you to deliver the baby early, rather than trying to stop labor. This choice is usually made when the mother is suffering from an infection of the amniotic fluid and uterus, or has illnesses such as severe preeclampsia or eclampsia (forms of high blood pressure that occur during pregnancy). Delivering the baby prematurely may also be preferable if fetal evaluation shows that the fetus is not doing well, if there is placenta previa (placenta covering the cervix) that bleeds a lot, if there is abruptio placentae (detachment of the placenta) or if certain birth defects or malformations are identified.

Prevention

The most important thing you can do to try to have a healthy baby is to get early and adequate prenatal care. In fact, the best prenatal care begins even before you are pregnant. That way, you can be sure that you are in the best of health before pregnancy. Your practitioner will screen you for risk factors of premature delivery and discuss which precautions you could take. Measuring the length of the cervix using a special transvaginal ultrasound probe can predict a woman's risk of delivering prematurely. This is usually done in the doctor's office between 20 and 28 weeks of pregnancy. Researchers are studying vaginal secretions called cervicovaginal fetal fibronectin as a possible predictor of preterm labor. A woman at increased risk for premature delivery can be forewarned about what to do if symptoms occur, and may undergo further screening tests.

If you think that you broke your water, call your provider right away or go to the hospital. If you think that you are experiencing preterm contractions, you should stop what you are doing, go to the bathroom to empty your bladder, and then lie down on your left side. You should drink two glasses of water and juice, and try to relax. Many times, women are able to stop contractions by making sure that they are well hydrated and resting. If you continue to have four or more contractions per hour, call your health-care provider.

Call Your Doctor If:

  • You are having at least four contractions every hour, even if they're painless.
  • You have low, menstrual-like cramps.
  • You have a low, dull, constant backache.
  • You notice a change in your vaginal discharge, or a gush or slow leak of fluid from your vagina.
  • You notice a sensation of pelvic pressure.
  • You have abdominal cramping, gas or diarrhea.

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