Preterm Labor and Birth
Preterm Labor and Birth
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.
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
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
- 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.