Preterm Birth Prevention Clinic

Preterm birth may occur when a pregnant woman has labor contractions before 37 weeks of pregnancy. Around 1 in 10 babies are born prematurely.

Babies born before their term have a higher chance of complications since their organs are not mature enough to fully withstand the external environment. In particular, they have a higher risk of having difficulty in breathing (called respiratory distress), and a higher chance of brain complications (intraventricular hemorrhage), bowel complications (necrotizing enterocolitis), and are prone to serious infections since their immune system is also immature. In general, the earlier in the pregnancy the babies are born, the more vulnerable they are to these complications. Babies born at 23 to 24 weeks of pregnancy have a small chance of surviving. After 24 to 28 weeks, and especially after 32 weeks of pregnancy the chances of survival without significant long-term problems increases significantly. This depends on how healthy the baby is and the available newborn critical care services.

The causes for preterm labor are not fully known but there are many contributing factors including infection and inflammation, nature of the neck of the womb, placental bleeding, smoking, low maternal weight, twin or triplet pregnancies, and other possible associations. Once true preterm labor occurs, delaying delivery becomes difficult but there are few things to do in order to make sure that your baby is born in the best possible health. These include giving steroid injections to help mature the fetal lungs, giving magnesium injections to help protect the fetal brain, and transfer for birth in a hospital where the appropriate newborn critical care services are available.

Women who have had a preterm birth in a previous pregnancy are at a higher chance for recurrence. They are candidates for close monitoring during their current pregnancy to help reduce the chance for preterm delivery. At our clinic, we offer serial monitoring of cervical length (measuring the length of the neck of the womb using ultrasound) between 16 and 24 weeks of pregnancy. If the cervical length is short, medication (progesterone) is started or a small operation to put a stitch around the neck of the womb (cervical cerclage) is performed. This has been shown to be helpful in prevention of preterm birth recurrence. However, performing a cervical cerclage without evidence of a short cervix may be harmful, this is why its indiscriminate use for women with a history of preterm birth is not recommended. Depending on the mother’s history, we might also offer screening for certain vaginal infections (bacterial vaginosis) and treat if needed.

Dr Abi Nader specializes in diagnosing and treating high-risk pregnancies. Please do not hesitate to contact us for appointment and advice.