At NYU Langone, treatment for preterm labor depends on the unborn baby’s development, especially overall weight and gestational age, which is the number of weeks of pregnancy. If your doctor believes the baby is ready for birth, usually after 34 weeks of pregnancy, he or she may recommend that labor progress. If this occurs, you are admitted to the hospital, where NYU Langone doctors monitor and evaluate symptoms every few hours in order to detect any change that might signal that labor is imminent. But if the baby isn’t ready for birth, your doctor takes steps to delay labor for as long as possible.
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Depending on your symptoms and the baby’s gestational age, your doctor may prescribe medication to delay or stop preterm labor.
If a urine test during preterm labor diagnosis reveals a bladder, kidney, or urinary tract infection, your doctor prescribes antibiotics. Sometimes, managing the infection stops preterm labor.
If your amniotic fluid, or “water,” leaks or ruptures—a condition called preterm premature rupture of membranes—your doctor prescribes an antibiotic, which can cause labor to stop. Antibiotics can also prevent an infection in the amniotic fluid, membranes, or placenta when this occurs.
If you are showing signs of preterm labor and are less than 34 weeks pregnant, your doctor may administer a tocolytic medication to suppress labor and give your baby’s lungs more time to mature. Tocolytics can reduce contractions, thereby delaying labor, for up to several days. Nifedipine, which is given by mouth, is often the first treatment recommended by NYU Langone doctors.
Tocolytics may not be prescribed for women with certain health conditions, such as severe bleeding, which may be caused by the placenta detaching from the wall of the uterus, a rare condition called placental abruption. In these situations, labor may be allowed to progress for the safety of both the mother and the baby.
If labor is successfully stopped, you may be sent home from the hospital, and your doctor may ask that you restrict certain activities to prevent a recurrence of preterm labor symptoms. Often, this includes instructions for “pelvic rest,” which means that nothing is allowed in your vagina. This can help to prevent contractions, which can trigger labor. Doctors typically advise women to refrain from sexual activity and to decrease or eliminate strenuous activity, such as exercise and heavy lifting. Occasionally, you may be asked to stop working.
It is important to drink enough fluids when you are experiencing preterm labor, because dehydration can cause contractions. NYU Langone doctors advise drinking enough water to ensure your urine is pale yellow or almost clear—for most women, this is about 8 glasses (8 ounces each) per day.
A baby’s brain, intestines, and lungs continue to develop until delivery. If an early labor seems likely, treatment may be needed to speed up your child’s development in the womb. Your doctor may administer any of the following medications to help the baby’s development progress more quickly.
If you are less than 34 weeks pregnant and experiencing the symptoms of labor, your doctor may inject a corticosteroid called betamethasone into your arm, leg, or buttocks to help speed up the baby’s lung development and protect against brain complications. It is given twice, in doses 12 to 24 hours apart. Typically, betamethasone is injected in the hospital when it appears that labor may progress despite efforts to stop it. If you are at high risk for preterm labor, it may be administered in your doctor’s office even if no symptoms of labor are present.
If you are less than 32 weeks pregnant and showing signs of labor, your doctor may give you magnesium. Magnesium decreases the odds that a preterm baby may have neurodevelopmental delays, and it may also help to slow down contractions. It is administered into a vein through intravenous (IV) infusion in the hospital.
Women given magnesium are carefully monitored in the hospital for symptoms of magnesium toxicity, a rare condition that causes muscle weakness and breathing problems. Your doctor or nurse checks your vital signs, including blood pressure and pulse, every 30 minutes for the first two to three hours after treatment. To collect and monitor urine output, a small tube called a catheter is inserted into the urethra, which carries urine from the bladder out of the body. If signs of magnesium toxicity appear, your doctor stops the magnesium and may administer another IV infusion, this time of calcium gluconate, to reverse the effects.
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