If you went into preterm labor, is next pregnancy considered high risk?

flamencogal

I went into labor at 32 1/2 weeks (PROM) with DS and we would eventually like to have one more child. ?I'm trying to figure out/understand what would be done differently next time to try and prevent preterm labor. ?I had no warning signs--my water just broke at work sitting at my desk. I was even at the OB that same morning for a routine appt (although they did not do an internal--just measurements and heart beat).

Anyone have thoughts/ideas? ?I've heard about the progesterone shots. ?I'm also wondering if they will do more internals to check my cervix and put me on bed rest at the first sign of dilation/effacement? ?Would they also give me the steroid shot to mature the lungs just in case? I'm really clueless and my OB wasn't all that helpful when I asked about it. ?Needless to say, I will be switching OB practices for the next pregnancy. ?Thought this might be a good place to ask.

Thanks!?

schmoodle

I went into labor last time at 23 weeks without warning. I had my cervix checked manually a week before and everything was fine and I hadn't been contracting or had any other real signs. They think mine was caused by a placental abruption but they're not sure if that caused the labor or vice versa.

This time we are taking the following precautions:

1. Modified bedrest at 16 weeks - mostly because we have no idea what happened and just being as cautious as possible.

2. Weekly appts with cervical checks [ETA - I started weekly appts at 16 weeks, before that they were bi-weekly]. They checked manually at first, but then I was diagnosed with placenta previa, and they don't like to do manual cervical checks with that, so they now check visually or via ultrasound every few weeks.

3. P17 shots.

So far, things seem ok, although I'm at 22 weeks now at which point things seemed fine last time. I am having fewer pains/complaints this time, and no Braxton Hicks yet which I had starting at 14 weeks last time, but not sure if that's due to the precautions or because I'm having a singleton instead of twins this time.

cherryblossom25

I am interested to see what answers you get to this. I posted the same question recently on my usual board and 0-6 and didn't get a lot of answers - one girl said her OB would start internals at 20 weeks to check for dilation.

I started PTL at 30 weeks with my last pg, and was on bedrest and procardia for 6 weeks. My water didn't break though. I really wanted to ask my OB about this at my PP checkup but of course I forgot. I don't know if the next will be considered high risk, or if I'll be put on meds or bedrest as a preventative measure, but I know that I will be very proactive about getting checked out at the first sign of contractions.... although hopefully it won't happen again. I don't think they give the steroid shots as a "just in case" though - I could be wrong, but I think they will only do that if you are showing signs of possibly delivering early.

If you don't feel your OB is being attentive enough to your concerns, absolutely switch! I did partway through my pregnancy and it was the best thing I could have done - my OB now is wonderful. Good luck to you!

lilwifey2be

Im glad you asked this question.  I went into PTL at 30 weeks, like you had no warning signs or anything.  They think mine was abruption related as well because i had a ton of bleeding.  I dont have an answer for you but can relate and was curious about the same thing. 

Rossi17

I went into preterm labor at 18 weeks. Here is what the doctor and my perinatalogist are doing for me:

- cervical lengths through ultrasound every 4 weeks since 12 weeks, could be more often if the cervix would become shorter than 3 cm.

- I just started my weekly progesterone shots this week

- I have a level 2 u/s in a couple of weeks

- at about 24 weeks until about 37 weeks, my doctor will begin doing a weekly cervical culture to see if an enzyme that predicts labor within the next week is present (with very high accuracy rate, he says it's like 80-90%) 

Wally3

It is wierd my story is almost exactly the same as yours, except 2 weeks later.  I had my 34 wk apt in the morning and everything was normal.  Then my water broke at work the same day, I had DS later that evening. I have been wondering about my next pg.  I didn't asked at my 6 wk appt because I was still to overwhelmed to think about another child.

jd0614

I just ventured over to this board since I was high risk with my boys.  To answer your question - my DS was born at 33 weeks with no warning - like you, my water just broke randomly and he was born 9 hours later.  My 2nd pregnancy was twins which is high risk automatically at my OB, however, before we knew it was twins I was considered High risk.  Hope that helps!

Descanso*Bride

My water broke at 34 weeks and my OB found out during my c-sec that I have a bicornuate uterus.  DS literally ran out of room as he was wedged in one of the "horns".  OB said that any future pregnancies would be considered high-risk, he would recommend doing a cerclage and see a perinatologist.

MrsSmith81

My dr said she isn't going to take any chances. I had an irritable uterus and started contracting/dilating at 24 wk despite bedrest and meds. I ended up delivering at 36wk when my water broke. My dr is going to start weekly internals at 20wk next time so we can catch anything early if it happens again.