Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
|
|
 Ask Dr. Greenfield
Preventing Preterm Labor | | | QUESTION | | | | My first baby came five weeks early. Is there anything I can do to help prevent preterm labor from happening this time around? — Early Bird | | | ANSWER |
April 29, 2003 | | | While some women have ongoing risk factors for premature birth, like an unusually shaped uterus, a woman who's had one "unexplained" preemie only has about a 15 percent chance of giving birth early again. That means you probably have about an 85 percent chance that you will have a full term baby next time around.
What can you do to help prevent preterm labor? Some of these are things that anyone can do to decrease the chances of having a premature baby--whether they had a preemie before or not.- Avoid cigarettes and drugs.
Smoking and cocaine use are both risk factors for prematurity.
- Space pregnancies between 18 months and 5 years apart.
Closely spaced babies increase the chances of premature birth
- Take care of your teeth.
Believe it of not, there may be an association between gum disease and preterm birth, so see your dentist and keep your teeth healthy.
- Talk to your doctor about your activity level to see what he recommends.
For women at increased risk of premature labor, it isn't clear whether heavy physical exertion, like working more than a normal full time job or being on your feet all day, increases your risk, but it makes sense not to overly exert yourself if you are already at some increased risk. That said, there isn't any evidence (despite decades of recommendations) that strict bed rest prevents babies from coming early.
Your doctor will probably schedule frequent prenatal appointments for you in the third trimester. Pay attention to how you feel and report any unusual symptoms like contractions, loss of fluid, vaginal bleeding, urinary tract infection or vaginitis, so that you can get timely evaluation and treatment. If you are having contractions or changes of your cervix upon internal examination, tests like ultrasound imaging of the cervical length and fetal fibronectin, a chemical test of the secretions from the cervix, can help distinguish preterm labor from false alarms.
Medications (like magnesium sulfate) used to stop preterm labor are of limited effectiveness, but they may buy some time so that a mother in premature labor can get corticosteroids, a medication that may help the baby's lungs mature more quickly. Recent studies indicate that the hormone progesterone, given as a daily vaginal suppository, looks promising as a method to prevent premature labor. While progesterone treatment isn't currently standard care, researchers are studying this further to see if women who are at increased risk for premature birth should use progesterone during pregnancy.
Despite all these recommendations, remember that, no matter what, you are most likely to give birth to a full term healthy infant this time around. Good luck!
— by Marjorie Greenfield, M.D. |
|
