For some women, a surgical procedure known as cervical cerclage can help women who develop preterm labor because of a short cervix. During this procedure, the cervix is stitched closed with strong sutures. Typically, the sutures are removed during week 36 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. In addition, your health care provider might give you medications to temporarily halt preterm contractions so that medications can be given to mature your baby’s lungs. Once you’re in labor, there are no medications or surgical procedures available to stop labor. However, your doctor might recommend the following medications:
- 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. Corticosteroids also might be recommended starting at week 23 of pregnancy, if you're at risk of delivering within 7 days. In addition, corticosteroids might be recommended if you're between weeks 34 and 36 and 6 days of pregnancy, at risk of delivering within 7 days and you haven't previously received them. You might be given a repeat course of corticosteroids if you're less than 34 weeks pregnant, at risk of delivering within 7 days and a prior course of corticosteroids was given to you more than 14 days previously.
- Magnesium sulfate. Your doctor might offer magnesium sulfate if you have a high risk of delivering between weeks 24 and 32 of 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 won’t 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.
Oct. 19, 2016
- Lockwood CJ. Overview of preterm labor and birth. http://www.uptodate.com/home. Accessed Sept. 30, 2014.
- Cunningham FG, et al. Williams Obstetrics. 24th ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://accessmedicine.mhmedical.com/book.aspx?bookid=1057. Accessed Oct. 3, 2014.
- 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.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice. ACOG Practice Bulletin No. 677: Antenatal corticosteroid therapy for fetal maturation. Obstetrics & Gynecology. 2016;128:187.