8/11/2019 Women at Risk for Preterm Labor
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Women at risk for preterm labor, particularly those who have had
one or more premature
births, may be candidates for one or more of the following
treatments:
Progesterone:The medication progesterone has been used to
prevent miscarriage and
preterm birth for over 40 years. Although it has been used for a
long time, studies disagree
on whether or notprogesteroneactually works to prolong pregnancy
in women who are at
risk for premature birth. Cerclage:Acerclageis a stitch placed
in the cervix to hold it closed. Cerclages have been
used for over 50 years to prevent preterm birth. New research
shows that cerclage does not
stop labor once it has begun, but it can prolong pregnancy in
some women.
Bedrest:Although it is still used, especially in twin or higher
pregnancies, bedrest alone is
ineffective at preventing preterm birth. In fact, routine
bedrest may actually increase the
rate of preterm birth in some women.
Antibiotics:Antibiotics may be given to women with preterm
premature rupture of
membranes (PPROM), a bag of water that has broken before the
baby is due. Infection
seems to be a risk factor for premature labor, and women with
PPROM are at risk for uterine
infection. Giving antibiotics can prolong pregnancy in women
whose water breaks early.
Goals for Treating Preterm Labor
Happily, most women at risk for preterm labor will go on to
deliver healthy, full term babies.
But doctors are largely unable to prevent premature birth in
women who are already showing
signs of preterm labor. Even the most effective interventions
usually only delay birth for a day
or two.
Because treatments for preterm labor only delay birth for a
short time, the major goals of these
treatments are to allow enough time to transfer a mom in
premature labor to a hospital that
has aNICU,and forsteroidsto be given to the mother. Steroids
have been shown to speed upfetal lung development, making healthier
preemies who require shorter NICU stays.
Medications to Treat Preterm Labor
Medication is the most common treatment for premature labor.
Some medications,
calledtocolytics,affect the uterus directly to slow or stop
contractions.
Magnesium sulfate:Magnesium sulfateis the most commonly used
tocolytic. Magnesium
sulfate has two extra benefits that make it the most commonly
used tocolytic: It can prevent
seizures in moms with preeclampsia, and it may help to reduce
the incidence ofcerebral
palsyand other brain disorders in premature babies. Other
tocolytics:Medications that affect the heart and lungs also affect
the uterus, so
doctors often use heart and lung medications to slow premature
labor. Heart medications,
such asnifedipine,and lung medications, such asterbutaline,are
some of the more common
medications used as tocolytics.
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