Women at risk for preterm labor, particularly those who have had one or more premature

births, may be candidates for one or more of the following treatments:

Progesterone: The medication progesterone has been used to prevent miscarriage and
preterm birth for over 40 years. Although it has been used for a long time, studies disagree
on whether or notprogesterone actually works to prolong pregnancy in women who are at
risk for premature birth.
Cerclage: A cerclage is a stitch placed in the cervix to hold it closed. Cerclages have been
used for over 50 years to prevent preterm birth. New research shows that cerclage does not
stop labor once it has begun, but it can prolong pregnancy in some women.
Bedrest: Although it is still used, especially in twin or higher pregnancies, bedrest alone is
ineffective at preventing preterm birth. In fact, routine bedrest may actually increase the
rate of preterm birth in some women.
Antibiotics: Antibiotics may be given to women with preterm premature rupture of
membranes (PPROM), a bag of water that has broken before the baby is due. Infection
seems to be a risk factor for premature labor, and women with PPROM are at risk for uterine
infection. Giving antibiotics can prolong pregnancy in women whose water breaks early.
Goals for Treating Preterm Labor
Happily, most women at risk for preterm labor will go on to deliver healthy, full term babies.
But doctors are largely unable to prevent premature birth in women who are already showing
signs of preterm labor. Even the most effective interventions usually only delay birth for a day
or two.
Because treatments for preterm labor only delay birth for a short time, the major goals of these
treatments are to allow enough time to transfer a mom in premature labor to a hospital that
has a NICU, and for steroids to be given to the mother. Steroids have been shown to speed up
fetal lung development, making healthier preemies who require shorter NICU stays.
Medications to Treat Preterm Labor
Medication is the most common treatment for premature labor. Some medications,
called tocolytics, affect the uterus directly to slow or stop contractions.
Magnesium sulfate: Magnesium sulfate is the most commonly used tocolytic. Magnesium
sulfate has two extra benefits that make it the most commonly used tocolytic: It can prevent
seizures in moms with preeclampsia, and it may help to reduce the incidence ofcerebral
palsy and other brain disorders in premature babies.
Other tocolytics: Medications that affect the heart and lungs also affect the uterus, so
doctors often use heart and lung medications to slow premature labor. Heart medications,
such as nifedipine, and lung medications, such as terbutaline, are some of the more common
medications used as tocolytics.