For some women, a surgical procedure known as cervical cerclage can help prevent premature birth. During this procedure, the cervix is stitched closed with strong sutures. Typically, the sutures are removed when the baby is considered full term — during week 37 of pregnancy. If necessary, the sutures can be removed earlier.
Cervical cerclage might be recommended if you're less than 24 weeks pregnant, you have a history of early premature birth and an ultrasound shows that your cervix is opening or that your cervical length is less than 25 millimeters.
If you're before week 34 of your pregnancy and in active preterm labor, your health care provider might recommend hospitalization. If you need it, pain relief is available. In addition, your health care provider might give you medications to temporarily halt preterm labor or promote your baby's readiness for birth, including:
- Corticosteroids. If you're between weeks 24 and 34, your health care provider might recommend an injection of potent steroids to speed your baby's lung maturity. After week 34, your baby's lungs might be mature enough for delivery without steroids.
- Magnesium sulfate. Although this medication isn't likely to prolong your pregnancy, some research has shown that it may reduce the risk of a specific type of damage to the brain (cerebral palsy) for babies born before 32 weeks of gestation.
Tocolytics. Your health care provider might give you a medication called a tocolytic to temporarily stop your contractions. These medications aren't likely to halt preterm labor for longer than two days because they don't address the underlying cause of preterm labor.
However, they might delay preterm labor long enough for corticosteroids to provide the maximum benefit or, if necessary, for you to be transported to a facility that can provide specialized care for your premature baby.
Your health care provider can help you weigh the risks and benefits of using a tocolytic. In addition, your health care provider won't recommend a tocolytic if you have certain conditions, such as pregnancy-induced high blood pressure.
If you're not hospitalized, you might need to schedule weekly or more-frequent visits with your health care provider so that he or she can monitor signs and symptoms of preterm labor.
Dec. 04, 2014
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- Frequently asked questions. Labor, delivery and postpartum care FAQ087. Preterm (Premature) labor and birth. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/Preterm-Premature-Labor-and-Birth. Accessed Sept. 30, 2014.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 127: Management of preterm labor. Obstetrics & Gynecology. 2012;119:1308.
- Norwitz ER. Prevention of spontaneous preterm birth. http://www.uptodate.com/home. Accessed Sept. 30, 2014.
- Robinson JN, et al. Risk factors for preterm labor and delivery. http://www.uptodate.com/home. Accessed Sept. 30, 2014.
- DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology.11th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://accessmedicine.mhmedical.com/book.aspx?bookid=498. Accessed Oct. 3, 2014.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 142: Cerclage for the management of cervical insufficiency. Obstetrics & Gynecology. 2014;123:372.
- Creasy RK, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, Pa.; Saunders Elsevier: 2014. http://www.clinicalkey.com. Accessed Sept. 30, 2014.
- Frequently asked questions. Labor, delivery and postpartum care FAQ004. How to tell when labor begins. American College of Obstetricians and Gynecologists. http://www.acog.org/Patients/FAQs/How-to-Tell-When-Labor-Begins. Accessed Oct. 6, 2014.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 14, 2014.
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