Preterm Labor & Cervical Concerns: A 24-Week Pregnancy - Seeking Expert Advice

Question
Hello,
I am 23, this is my 4th pregnancy. I had one termination. I have two children.. One born at 37 wks and the last born at 35 wks. Both had preterm labor with terb shots. I am 24 wks pregnant with an expected due date of 1/14/05 . I had cramping problems ..was sent into Labor & D.. they said I was 50 % effaced. so My midwife did a internal ultrasound and measured my cervix and said it was just about a 3.  Now I have an infection a week later which I have meds for. I still have been getting pains & yesterday they said I was 50 % effaced but still a lil thick.
Should I switch to a High risk doctor?


Answer
You do not need a high risk doctor. YOur cervix is still long enough (3cm) and you are not having uterine contractions, even though you are 50% effaced. There really is nothing you can do to stop preterm labor. However, bed rest, plenty of fluids (to maintain hydration) and "kick counts" will give you a better chance of maintaining the pregnancy. If you start to have contractions every 10 minutes lasting for more than  45 seconds, I would go to the hospital and get on a monitor. A subcutaneous shot of terbutaline would be helpful with I.V. hydration.A fetal fibrinolectin test may also be appropriate if you have the availability for one. This is a test that predicts your risk of preterm delivery. Discuss it with your doctor.