Preterm Labor Risk-Factors-What can I do about them? - Mothering Forums

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#1 of 7 Old 12-29-2003, 04:55 PM - Thread Starter
 
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I carried my son to 37 weeks, but had preterm labor episodes starting around 24 weeks. I was given 4 shots of terbutaline (brethine), and a prescription for it and for procardia, both of which I was taken off of at 36.5 weeks.

Because of my history, my doctor is set on catheterizing me to get a urine specimin (mine keep coming back contaminated), and I'm sure they want to keep testing me for STD's which I don't have. This irritates me something fierce; I only had one UTI while I was pregnant with Eli, I drank cranberry juice and it went away.

I tested positive for GBS at 30 weeks (they cultured me because I was contracting regularly & it looked like I was in labor) and again at 35 weeks. This didn't come as a surprise to me, because I am a carrier for group A strep (the kind that gives most people a sore throat) and have been since childhood. I got loads of antibiotics in labor and still developed a fever... but that's a whole different story. The point is, I've read that GBS is a risk factor for preterm labor.

My other vaginal cultures all came back "inconclusive"; in fact, everything they took from me came back that way except the GBS culture. I don't want them taking all the samples this time! It drives me crazy, and I don't have the energy to put up with it! I've been with the same man for 4.5 years, he hasn't been with anyone else, and we still don't have any STDs. If my cultures are "inconclusive", isn't there a potential that they were negative?

At any rate, they're being very cautious, testing for everything again, because of the risk of preterm labor. So what can I do to minimize those risks? I don't want to have another NICU baby, but I don't think that any of the things they did the last time helped; half a dozen inconclusive cultures just lead to overprescription of antibiotics. I did have 2 of the three major risk factors for development of GBS in my son (prolonged rupture of membranes & fever during labor), but I got 4 doses of antibiotics (every 6 hours while I was in the hospital laboring) and 2 of them were before the fever developed. My son still had trouble breathing (way too fast!) and was definately ill, to say nothing of my problems.

I would like to do everything in my power to eliminate risk factors for preterm labor long before I get to that point. If I can avoid it entirely, so much the better!

Rynna, Mama to Bean (8), Boobah (6), Bella (4) and Bear (2)
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#2 of 7 Old 12-30-2003, 03:18 AM
 
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Did they give you abx during pregnancy or just during labor? IF you were on any abx for anything (sinus infection for example) when they did the vag cultures they would all be inconclusive because the abx affect the bacteria from growing out on the culture medium.

Have they done the initial panel for STDs this time around? I'd let them do that, but only if you are not on abx. Once they come back clear then don't let them do them again.

I know that my friend was part of the "no preterm labor" club at Kaiser (they actually have a nurse call high risk people at least once a week to check on how they are doing... more often if they are at really high risk). They gave her a gigantic water bottle and told her to drink three of them each day. She also had orders to keep her feet up when sitting and not to stand in one place too much to avoid pressure on the cervix. Also she was working, but was told absolutely no overtime.

Those are just the things she did. I don't know what else you might do. Good luck!
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#3 of 7 Old 12-30-2003, 03:36 AM
 
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I would give this a try... I know there are some hypnosis tapes that deal with this. The HypnoBabies website sells one for $10. plus $1.5 s/h

Quote:
3) Baby, Stay IN!(CD or Audio Tape)
Excellent for anyone experiencing Pre-Term Labor, this script brings you deeply into hypnosis and calms down uterine activity, has sugestions for keeping the cervix closed until at least 37 weeks gestation, (or until it is safest for baby to come out) and allows you to communicate with your unborn baby, programming your inner mind and your little one to work together to keep the baby safe and healthy until it is safe for him/her to be born.
I'm a big fan of HypnoBirthing - it helped me have a painfree 18 hour labor in the hospital.

10 - boy
5.5 - girl
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#4 of 7 Old 12-30-2003, 05:20 PM
 
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From Dr. Christiane Northrup's website...

"In a study of 64 women, Dr. Lewis Mehl–Madrona found that fear, anxiety and stress; lack of support from the woman’s partner; poor maternal self-identity; negative beliefs about birth; and lack of support from friends and family predicted deliveries that required obstetrical intervention ranging from cesarean section to oxytocin augmentation or induction. Mehl–Madrona also found that when he used hypnotherapy on these women, reassuring them that that they were doing their best, allowing them to state their stresses, and reinforcing that their bodies knew what to do, many were able to avoid giving birth prematurely. "

I thought that was very interesting...

sending you and your baby warm, peaceful thoughts...

--claudia
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#5 of 7 Old 12-30-2003, 08:48 PM - Thread Starter
 
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Quote:
Originally posted by TurboClaudia
From Dr. Christiane Northrup's website...

"...fear, anxiety and stress;...negative beliefs about birth;
Well, I've got these two in abundance... though I suppose that's obvious from the fact that I posted this already and I'm only 14 weeks pregnant. : I have loads of support from dh, family, & friends. It's the stuff in my head I'm having a hard time with.

Rynna, Mama to Bean (8), Boobah (6), Bella (4) and Bear (2)
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#6 of 7 Old 12-31-2003, 06:27 AM
 
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I had a 35 weeker after 9 wks of bedrest and oral terbutaline. I'm 30 wks with #2, so I understand your concerns about PTL.

I switched OBs this time around - and my new ob has some intersting views about PTL and its treatment.

He says that a lot of what we (in the medical community) do to 'keep babies cooking' has more to do with conventional wisdom than with actual scientific findings - this includes bed rest, drinking lots of water, and use of terbutaline and other meds to stop ctx.

He says that studies have shown that terbutaline buys about 3 days - enough to get cortisone shots for the baby's lungs. He says that women tend to develop an immunity to the effects of terbutaline within a matter of days. I thought that was pretty interesting since I was on it for 9 wks with my previous baby.

He caveats this by saying that even though there isn't real scientific evidence that bed rest or drinking water helps, he'll still prescribe it because it can't hurt.

We've talked about my concerns about having problems this time around - and he says pretty much, if a baby is going to come early, there isn't a lot we can do to prevent it - the key is to get those cortisone shots in time.

I have appreciated my doctor's candor about much of the guesswork of obstetrical work. In some respects it helps me feel better about the uncertainty.

If you are unsatisfied with the way your doctor is handling this pregnancy, have a conversation with him/her. Have them identify their concerns, the tests they would like to do and their 'plan' to help minimize your risks. If you're still not satisfied - and you can find another doctor (by word of mouth, or by calling around), find someone who will be more responsive to your concerns - and will treat you in a manner which makes you comfortable.

Isn't it amazing how much anxiety comes with pregnancy - even if you've already been through it once!

Good Luck!
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#7 of 7 Old 12-31-2003, 01:37 PM
 
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I'm 21 weeks pg and in the possible PTL category as well due to placenta bleeding. Sorry I don't have any words of wisdom but wanted to lend my support. I agree with UD_CHICK replies....we've been told there is no "real" scientific evidence about bed rest, drinking water/cranberry juice but I've been on modified bed rest since 6 weeks. I drink alot of herbal teas, acupuncture, chiropractor adjustment and bed rest and believe I would have miscarried if I hadn't taken it easy.

Take care of yourself. We are in this together and I'll be praying for you.

Chrissy
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