women s health issues
Preterm Labor
Treatment of Preterm Labor
Sometimes allowing labor to continue Antibiotics until infection is ruled out If labor needs to be delayed, rest, fluids, drugs that slow labor, antibiotics, and sometimes corticosteroids If vaginal bleeding occurs or the membranes around the fetus rupture, allowing labor to continue is often best. If vaginal bleeding does not occur and the membranes are not leaking amniotic fluid (the fluid that surrounds the fetus in the uterus), the woman is advised to rest and to limit her activities as much as possible, preferably to sedentary ones. She is given fluids and may be given drugs that can slow labor. These measures can often delay labor for a brief time. Drugs that can slow labor include the following: Magnesium sulfate:This drug is often given intravenously to stop preterm labor, particularly if the pregnancy is less than 32 weeks. Magnesium sulfate also appears to substantially reduce the risk of bleeding in the brain and the resulting problems with development of the newborn's brain, such as cerebral palsy. However, if the dose is too high, it may affect the woman’s heart and breathing rates. Calcium channel blockers:These drugs are usually used to treat high blood pressure. They sometimes cause headaches and low blood pressure in the woman. Prostaglandin inhibitors:These drugs may temporarily reduce the amount of amniotic fluid. They are not used after the 32nd week of pregnancy because they may cause heart problems in the fetus. Women are given antibiotics until culture results are obtained. If results are negative, the antibiotics are then stopped. If the cervix opens (dilates) more than 2 inches (5 centimeters), labor usually continues until the baby is born. If the membranes rupture between the 24th and 34th week of pregnancy, corticosteroids are given to help the fetus’s lungs mature, unless delivery is expected soon. Doctors also consider giving women corticosteroids if the membranes rupture Between 34 and 37 weeks of pregnancy if women are at risk of preterm delivery and have not been given any corticosteroids earlier in the pregnancy Starting at 23 weeks of pregnancy if women are at risk of preterm delivery within 7 days The corticosteroid helps the fetus’s lungs and other organs mature more quickly. It also reduces the risk that after birth, the baby will have difficulty breathing ( Respiratory Distress Syndrome in Newborns ) or other problems related to prematurity (such as bleeding in the brain). In future pregnancies, women who have had a preterm delivery may be given a progestin. This drug may reduce the risk of having another preterm delivery. The progestin is started during the 2nd trimester and continued until just before delivery. 