![]() If you are diagnosed with a short cervix before week 24 of pregnancy, your health care provider might also recommend use of progesterone until week 37 of pregnancy. In addition, your health care provider might offer progesterone, which is inserted in the vagina, as a preventive measure against preterm birth. If you have a history of premature birth, your health care provider might suggest weekly shots of a form of the hormone progesterone called hydroxyprogesterone caproate, starting during your second trimester and continuing until week 37 of pregnancy. If necessary, the sutures can be removed earlier.Ĭervical cerclage might be recommended if you're less than 24 weeks pregnant, you have a history of early premature birth, and an ultrasound shows your cervix is opening or your cervical length is less than 25 millimeters. Typically, the sutures are removed after 36 completed weeks of pregnancy. During this procedure, the cervix is stitched closed with strong sutures. If you are at risk of preterm labor because of a short cervix, your doctor may suggest a surgical procedure known as cervical cerclage. 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. Your health care provider won't recommend a tocolytic if you have certain conditions, such as pregnancy-induced high blood pressure (preeclampsia). Tocolytics don't address the underlying cause of preterm labor and overall have not been shown to improve babies' outcomes. Tocolytics may be used for 48 hours to delay preterm labor to allow corticosteroids to provide the maximum benefit or, if necessary, for you to be transported to a hospital that can provide specialized care for your premature baby. Your health care provider might give you a medication called a tocolytic to temporarily slow your contractions. Some research has shown that it might reduce the risk of a specific type of damage to the brain (cerebral palsy) for babies born before 32 weeks of gestation. Your doctor might offer magnesium sulfate if you have a high risk of delivering between weeks 24 and 32 of pregnancy. You might be given a repeat course of corticosteroids if you're less than 34 weeks pregnant, at risk of delivering within seven days, and you had a prior course of corticosteroids more than 14 days previously. Your doctor may also recommend steroids if you are at risk of delivery between 34 weeks and 37 weeks. If you are between 23 and 34 weeks, your doctor will likely recommend corticosteroids if you are thought to be at increased risk of delivery in the next one to seven days. Corticosteroids can help promote your baby's lung maturity. However, your doctor might recommend the following medications:Ĭorticosteroids. Once you're in labor, there are no medications or surgical procedures to stop labor, other than temporarily. You'll also provide a urine sample, which will be tested for the presence of certain bacteria. These results will be reviewed in combination with other risk factors. Your health care provider might take a swab of your vaginal secretions to check for the presence of certain infections and fetal fibronectin - a substance that acts like a glue between the fetal sac and the lining of the uterus and is discharged during labor. Your health care provider might use a uterine monitor to measure the duration and spacing of your contractions. An ultrasound might also be done to check for problems with the baby or placenta, confirm the baby's position, assess the volume of amniotic fluid, and estimate the baby's weight. A transvaginal ultrasound might be used to measure the length of your cervix. Your health care provider might also check for uterine bleeding. If your water hasn't broken and there's no concern that the placenta is covering the cervix (placenta previa), he or she might also do a pelvic exam to determine whether your cervix has begun to open. ![]() Your health care provider might evaluate the firmness and tenderness of your uterus and the baby's size and position. Tests and procedures to diagnose preterm labor include:
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