Personalized Care for Preterm Labor

Preterm labor is labor that starts before 37 completed weeks of pregnancy. Labor is when the uterus regularly tightens and the cervix starts to thin and open. This lets the baby enter the birth canal early. If you have had previous preterm labor or signs of preterm labor, your doctor may refer you to a maternal fetal medicine doctor for specialized care.

Maternal fetal specialists are high risk pregnancy experts, also called perinatologists. These obstetrician-gynecologists have three to four additional years of advanced education and training in diagnosing, monitoring and treating pregnancy complications in a woman and her fetus. Their focus is keeping both mom and baby healthy before, during and after delivery.

Known Causes of Preterm Labor

The cause of preterm labor is unknown in most women. However, some causes that can initiate preterm labor can be identified, including:

• Infections
• Vaginal bleeding
• Hormone changes
• Stretching of the uterus, from more than one fetus, a large fetus or too much amniotic fluid

Proactive Approach to Treating Preterm Labor

When concerns of preterm labor are identified, our team takes a proactive approach to care. Treatment for preterm labor may include bed rest either at home or in the hospital as well as:

• Cervical cerclage: This procedure is used to stitch the cervix closed. It may be done when the cervix is weak and not able to stay closed.
• Corticosteroids: This medication may help the lungs of your baby grow and mature. Preterm babies’ lungs may not be able to work on their own.
• Medications: Antibiotics may be used to treat a bacterial infection or if your water breaks. Tocolytic medicines help slow or stop contractions. They may be given as a shot (injection) or into the vein (intravenously).

If you are at high risk for preterm birth, your provider may give you the hormone progesterone. It helps reduce the risk for preterm birth if you have had a preterm birth in the past.

If treatments do not stop preterm labor or if you or your baby is in danger, our team will deliver your baby, perhaps by cesarean delivery. You can rest assured that our team is ready for any preterm issue. University Hospitals is one of a few facilities in the country with complete obstetric, delivery, newborn, pediatric and adult services and specialists all in one place. Our patients benefit from the vast expertise we can provide to prevent preterm labor and birth.

Understanding Preterm Labor Symptoms and Risk Factors

It is always important to be mindful of any changes you may experience during pregnancy. Signs of preterm labor might include:

• Belly cramps with or without diarrhea
• Changes in your vaginal discharge, including water, mucus or blood – or more vaginal discharge than usual
• Constant dull backache
• Pressure in your pelvis or lower belly, feeling like your baby is pushing down
• Regular or frequent contractions that make your belly tighten like a fist
• Your water breaks or early breaking of sac around the fetus, called premature rupture of membranes

Most women who have preterm labor have no known risk factors. But sometimes certain factors raise a woman's risk for preterm labor. Risk factors for the mother include:

• Abnormally shaped uterus
• Placenta in an abnormal position
• Placenta that separates from the uterus early
• Cervix not able to stay closed
• Age: under 20 or over 35 years old
• Being African American
• Having a preterm birth in the past
• Long-term illness such as heart disease or kidney disease
• Smoking
• Stress
• Using illegal drugs, such as cocaine

Neonatal Complications of Preterm Labor

Preterm labor may result in preterm birth. Although most babies are born after 37 weeks, those born preterm are at increased risk for complications, including problems with fetal growth or birth defects.

Premature babies are born before their body and organ systems have fully matured. These babies are often small, with a low birth weight, less than 2,500 grams or 5.5 pounds. They may also need help breathing, eating, fighting infection and staying warm. Babies born before 28 weeks are at the greatest risk for complications, including:

• Trouble maintaining body temperature or staying warm
• Breathing problems
• Heart and blood vessels problems, including heart defects and blood and heart rate problems
• Blood problems, including low red blood cell counts (anemia), yellow color to the skin from breaking down old red blood cells (jaundice), or low blood sugar (hypoglycemia)
• Kidney problems
• Digestive problems, including trouble feeding and poor digestion
• Nervous system problems, including bleeding in the brain or seizures
• Infections

Premature babies can have long-term health problems, as well. Generally, the more premature the baby, the more serious and long-lasting are the health problems. It is important to have the highest level of specialized newborn care possible.

Expert Care for High-Risk Pregnancy and Level IV NICU – all Under One Roof

We are one of the few facilities in the nation with a high-risk labor and delivery unit just steps away from a Level IV neonatal intensive care unit that is the highest ranked in northern Ohio and in the top tier in the nation. This enables us to keep mothers with their newborns for the safest, most successful outcomes.

Preconception Counseling for Previous Preterm Labor

If you have experienced preterm labor in the past and are considering getting pregnant again, it is important to have preconception counseling with one of our maternal fetal medicine specialists at University Hospitals.