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Treatments and drugs
By Mayo Clinic staff
Treatment may focus on women in preterm labor or on newborns after delivery.
For mothers
If you're experiencing preterm labor, treatment depends on your stage of pregnancy and how far labor has progressed. Sometimes rest is enough to stop premature contractions.
If you're not having contractions but your cervix is opening, a surgical procedure known as cervical cerclage may help prevent premature birth. During this procedure, the cervix is stitched closed with strong sutures. The sutures are removed in the last month of pregnancy.
In other cases, your health care provider may recommend medication. Some medications stop contractions by relaxing smooth muscles, including those of the uterus. Others block the production of substances that stimulate uterine contractions. These drugs may be given intravenously or by injection. Unfortunately, these medications typically stop labor only briefly — perhaps long enough to accomplish other goals, such as transferring you to a facility better equipped to care for a premature baby.
If your pregnancy is between weeks 23 and 34, your health care provider may recommend an injection of potent steroids to speed your baby's lung maturity. After week 34, steroids may not be needed because fetal lung development is more advanced.
In a 2007 study, the heart drug nitroglycerin showed promise in stopping preterm labor and reducing newborn illness. Nitroglycerin, which can be absorbed through the skin, is thought to prolong pregnancy by relaxing the smooth muscles of the uterus. Researchers suspect that it might improve blood flow to the uterus and placenta as well. It's important to note that other drugs to stop labor have had similar early findings, only to be disappointing in practice. Additional studies are needed before nitroglycerin becomes a routine way to manage preterm labor.
For newborns
Hospital neonatal intensive care units (NICUs) are designed to provide round-the-clock care for premature babies and full-term babies who develop problems after birth. In the NICU, your baby will probably be kept in an incubator — an enclosed plastic bassinet that's kept warm to help your baby maintain normal body temperature. Because preemies have immature skin and very little body fat, they often need such care to stay warm.
Sensors may be taped to your baby's body to monitor blood pressure, heart rate, breathing and temperature. Caregivers may also use ventilators to help your baby breathe. This high-tech equipment may seem overwhelming at first, but it's all designed to help your baby.
At first your baby may receive fluids and nutrients through an intravenous tube. Breast milk may be given later through a tube passed through your baby's nose and into his or her stomach. When your baby is strong enough to suck, breast-feeding or bottle-feeding is often possible. The antibodies in breast milk are especially important for preemies.
Your baby's caregivers will help you learn how to touch and eventually hold and feed your baby. Talk or sing softly to your baby, or simply provide quiet company.
Taking your baby home
Your baby is ready to go home when he or she:
- Can breathe without support
- Can maintain a stable body temperature
- Can breast- or bottle-feed
- Is gaining weight steadily
Your baby's health care team will help you learn how to care for your baby at home. Keep in mind that preemies are more susceptible than are other newborns to serious infections, and their illnesses tend to progress more quickly. Schedule frequent checkups for your baby. Routine checkups are a great time to ask questions about caring for your baby.
