Preventing and Treating Preterm Labor: An Expert's Guide

Preterm labor is a serious medical condition that affects approximately one in ten births in the United States. It is the leading cause of neonatal death, excluding those related to congenital malformations. Fortunately, there are ways to prevent and treat preterm labor, and this article will provide an expert's guide to doing so. The first step in preventing

preterm birth

is to identify any risk factors that may be present.

A thorough medical history should be taken, including the patient's current symptoms, expected due date, medical history, medication use, and allergies. Additionally, a wet preparation and a potassium hydroxide (KOH) preparation should be obtained, as bacterial vaginosis is strongly associated with premature birth. If preterm labor is suspected, the patient's medical history, physical examination, and laboratory findings and ultrasounds should be thoroughly evaluated to determine if she meets the criteria for preterm delivery or if she is a candidate for parenteral tocolytic treatment. If labor is successfully interrupted, the patient may be sent home from the hospital and asked to restrict certain activities to prevent the symptoms of preterm birth from returning.

Corticosteroids are often given by injection and are most effective when given at least 24 hours before delivery. Other drug options for treating preterm birth include magnesium sulfate (which may reduce the risk of cerebral palsy) and tocolytics (which temporarily delay contractions). A single dose of terbutaline sulfate (Brethine, Bricanyl), 0.25 mg, may also be administered subcutaneously to allow time to discuss treatment options, move the patient, or differentiate premature birth from an irritable uterus. In addition to medical treatments, there are lifestyle changes that can help prevent preterm labor.

Pelvic rest—that is, not having sex or performing vaginal exams—is usually essential if you have premature contractions. It's also important to drink enough fluids when you have a preterm birth, as dehydration can cause contractions. If you have a history of preterm birth or premature birth, you are at risk of having a subsequent premature birth. Today, doctors must diagnose and treat preterm birth in the midst of substantial controversy over the effectiveness of preventive and therapeutic modalities.

However, with proper diagnosis and treatment, preterm labor can be prevented in less than half of mothers who give birth before 37 weeks of gestation.