Understanding Preterm Labor & Pregnancy Risks: A Personal Story

Question
Hello. A little about my history. In sept. 2006 i had went into preterm labor and had my baby at 19 weeks. Then in January 2007 I had a spontaneous miscarriage at about 6 weeks of pregnancy. Lastly, I go got pregnant again in April 2007 and was seen in the high risk clinic. They measured the length of my cervix at 19 weeks and they said it was thick and long. Then exactly a week later i went into preterm labor again at 20 weeks of pregnancy. I was so confused because when they did my ultrasound they told me my cervical length was thick and long so i dont understand how it couldve shortened in just a week. Now i am pregnant again and am currently 17 weeks. what do you think my problem is and what could possibly help me.?

Answer
Dear Annissa,

Unfortunately, there is absolutely no way for me to know what is causing you early labors and pregnancy losses. I so very much wish I could. However, since you did have the preterm labor/delivery so soon after the determination of a thick, long cervix, you can inquire as to whether you would benefit from a cervical cerclage. That is essentially when the cervix is sewn closed. However, typically this is done around the 13th week of pregnancy for those at high risk. And sometimes preterm labors aren't necessarily caused by a weak cervix, but from other causes. Other common causes are:

Infection - About 40-50% of all preterm labor can be traced to infection. Many women do not show classic signs of infection, like fevers.

Bleeding - This does include placental abruption, where the placenta tears away from the uterine wall too early. It also includes bleeding disorders that may be genetic or acquired.

Stretching of the uterus - The stretching or over-distension of the uterus has also been linked to preterm labor and birth. This can be caused by uterine fibroids, multiple pregnancies (twins, triplets, etc.), or even having too much amniotic fluid (polyhydramnios).

With your history, it sounds like bedrest might be the best alternative to consider to try to get further into the pregnancy this time. Regardless - you need to have a serious, in-depth conversation with your doctor(s) about what specific steps they intend to take to try to ensure that this pregnancy reaches an age of viability this time.

I am very sorry to hear of your difficulties and wish I could give you more specific answers. I wish you well and I will have a good thought for you.

Brenda