QuestionHi. I would like to know about preterm labour. Recently, (at 20 weeks), I went to the doctor because I had a mucous discharge with a light streak of blood. The doctor sent me right away to the hospital where I later received stiches because they told me I had an incompetent cervix. The doctor who did the stiches to close my cervix told me that I would most likely have a preterm labour. What does that mean in terms of timing. In other words, how will I know when I will go into labour? Will there be any time frame that I will go into labour, or does labour just suddenly start? Because I was told that I would probably have preterm labour (I am 21 weeks on Jan. 18/05), should I be getting/taking injections for the development of the baby's lungs and if so, when should I start receiving the injections? As well, I was also told that there is a possibility of having a child with disabilities because of having an incompetent cervix if it is born at six months. Anoter doctor told me that I should not worry about this because my sac has not opened and the baby has developed normally according to all of the utlrasounds I had during the first three months of pregnancy. What is your opinion regarding the above?
AnswerIf they decided to put in a McDonald Cerclage, the cervix must have been opening a bit. With the stitch, however, it is unlikely that you will, indeed, go into preterm labor (that is the purpose of the stitch). However, if you do start to have preterm labor, you will notice contractions starting, from time to time. When you start to have contractions (a tightening of your belly at the level of your belly button) that occur more than 10 minutes apart (from the beginning of one contraction to the beginning of the next contraction) and each contraction lasts longer than 40 seconds in duration, call your doctor. You should drink plenty of water. Dehydration can cause preterm contractions. If you are admitted to the hospital with preterm labor, if it occurs prior to 32 weeks gestation, they will try to stop the contractions using terbutaline, and may even send you home with oral terbutaline (Brethine) or with a terbutaline pump. At that time, you will get 2 doses of steroids to try to help mature the baby's lungs. (We do not give more than 2 doses and therefore, you will not get steroids unless you are actually in labor). Certainly, if you deliver a baby that is premature or immature, it can have developmental disabilities. However, this would be solely on the basis of prematurity, not because you had an incompetent cervical os. If you do get at least to 35 weeks, the baby should be fine. Often, the stitch works so well that I have to cut it out at 42 weeks and induce labor in the patient. Don't worry.
