Prevention of Preterm Labor-Pregnancy

The causes of preterm labor are not entirely understood and, so far, its prevention eludes medical science. Obvious preventive measures include the elimination of the risks noted earlier. Avoid smoking, drinking, and recreational drug use. Report signs of urinary tract or vaginal infections to your physician or midwife so they can be treated promptly. Let your physician or midwife know if you have had a prior preterm birth .

If your work involves heavy physical labor, rotating or night shifts, long periods of standing, or makes you excessively tired, consider changing or reducing your workload. Unfortunately, women in the United States are not uniformly guaranteed paid maternity leave.

As sexually transmitted infections may be implicated in premature rupture of the membranes and preterm labor, you should use a condom if you are at risk for such an infection. Being at risk means that either you or your partner has more than one sexual partner. If you have any doubt about whether this is the case for your partner, or you have had a pre term birth, you should use condoms. In fact, because semen contains prostaglandins-body chemicals that cause uterine contractions-use of a condom from midpregnancy to 37 weeks gestation is a good idea for any woman who has had a previous preterm birth. The condoms provide a barrier between your body and your partner’s semen.

If you have a history of pre term labor or signs of preterm labor, avoid nipple or breast stimulation in the third trimester, before 37 weeks gestation, as this initiates uterine contractions. Abstain from orgasm if there is any question of threatened preterm labor, as it can lead to contractions.

There is some evidence, although not conclusive, that calcium supplementation may help prevent preterm labor. Routine calcium supplementation is not currently advised in pregnancy, but you should certainly maintain an adequate dietary intake of calcium sources. Except for sometimes causing constipation, a calcium supplement is not dangerous in pregnancy. If you have had a preterm birth, discuss with your physician or midwife whether or not they advise calcium supplementation as a possible preventive measure.

In the 1980s, some promising studies showed that preterm birth might be prevented with frequent prenatal visits and vaginal examinations for women at risk for preterm labor. A number of “Prevention of Preterm” birth programs were funded by various governmental and private agencies. Unfortunately, these did not demonstrate that such measures were uniformly valuable in preventing preterm birth. Whether or not to do weekly or biweekly vaginal examinations or ultrasounds to check the cervix in the third trimester for women with a previous preterm birth remains controversial.

Researchers have tried to find biochemical markers in the blood, saliva, or vaginal secretions of a pregnant woman that might predict a preterm birth. One such chemical is fetal fibronectin. This can be detected in vaginal secretions. Unfortunately, while the absence of fetal fibronectin seems to be very predictive that preterm labor will not occur, its presence does not necessarily signal impending preterm labor. To date, it is not useful as a test for preterm labor. The benefit of testing for estriol in a pregnant woman’s saliva is also being investigated. Estriol is a hormone produced from chemicals secreted by the fetus’s adrenal gland and liver. Maternal estriol levels show a steep rise approximately three weeks before delivery-term or preterm. This hormone can be detected in the mother’s saliva. Saliva testing for women at high risk for a preterm birth might prove to be of predictive value, but then the question of what treatment to implement must be considered.

Some companies have marketed home uterine monitors in an effort to pick up uterine contractions before a woman might feel them. The American College of Obstetricians and Gynecologists has stated, “It is not clearly demonstrated that this expensive and burdensome system can be used to actually affect the rate of preterm delivery.” Women who have had previous preterm labors can use their own hands to palpate the top of their uterus one hour each day in the third trimester to feel for contractions that they do not perceive.