Nearly one in four pregnant women in the United States will be placed on bed-rest due to conditions that can lead to preterm birth. As you travel through your pregnancy journey, learn these four essential questions for talking to your OB about preventing preterm birth.
The length of the cervix from 14 to 24 weeks into a pregnancy is an excellent indicator of preterm birth risk. Most OBs schedule an ultrasound around 19 to 20 weeks. Ask the sonographer to record your cervical length at that time, and write it down in your pregnancy journal. If the length is less than four centimeters, request a transvaginal ultrasound for a more accurate measurement. If you experience any signs of preterm labor in the weeks that follow, request another transvaginal ultrasound for length comparison.
If you previously had preterm labor or a preterm birth, or you have a short cervix, ask your doctor about the benefits of 17P (17-alpha-hydroxyprogesterone caproate). This progesterone supplementation is currently available by injection, given weekly from 16 to 36 weeks.
The fetal fibronectin (fFN) test is a very effective tool for determining whether preterm labor is likely to happen soon. Fetal fibronectin is a sticky protein that keeps the baby's fetal membranes attached to the mother's uterus during pregnancy. This protein is normally detected before 22 weeks and after 35 weeks when it begins to break down naturally. This test may show that fetal fibronectin is present even before other signs of preterm labor occur. A negative result reassures you that there is more than a 99 percent chance you will not deliver within the next two weeks. A positive result does not guarantee that preterm labor will occur, but it does allow you and your doctor to develop a plan to try to help prevent preterm birth.
It's called women's intuition for a reason! You know your body best, and when something doesn't feel right or suddenly seems different, call your doctor. You may think you don't have the right words to describe what you're feeling, but you will. This is also when a pregnancy journal comes in handy for comparison between the good days and the not-so-good days. Nurses, midwives and doctors always prefer that you call, rather than wait until it is too late.
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