In the rest of the article, we will detail what is known about recurrent premature birth and what can be done to reduce the chances of recurrence.
Premature birth results from a combination of factors. We know how to point out some of the risk factors, but even if you carry some of them, you will not necessarily give birth early.
On the other hand, sometimes premature labor starts by itself and without any warning and unfortunately, even if you did everything required throughout the pregnancy, it is still possible to give birth prematurely.
The main risk factors known today for the development of recurrent premature birth are:
- Premature birth in the past - mothers who have previously given birth in a premature birth have a 25% - 35% chance of giving birth in a premature birth in the next pregnancy as well
- Twin pregnancy or multiple pregnancy - 50%-60% chance of premature birth
- A uterus with an abnormal structure such as a single or bicornuate uterus
- Cervix that has undergone surgical intervention such as conization
Additional risk factors at the time of becoming pregnant that are indicated in the professional literature and which were found to be related to repeated premature birth:
- Underweight or overweight before becoming pregnant
- Eating disorders such as anorexia or bulimia.
- Getting pregnant shortly after the previous birth. An interval of at least 18 months from the previous birth is recommended.
- Age under 17 or over 35.
- Pregnancy through in vitro fertilization (IVF) treatments
- History of preeclampsia
- sexually transmitted infectious diseases
- Exposure to air pollution and passive smoking
- Nonmedical drug use and prescription drug use
- Stress in everyday life.
- Low socioeconomic status
- Domestic violence
- A lot of standing on your feet
Medical risk factors that appear during pregnancy that may lead to the development of premature birth:
- A cervix diagnosed as short in the second or third trimester of pregnancy
- Vaginal bleeding in the second or third trimester of pregnancy
- Urinary tract and vaginal infection.
- Early water drop.
If there is a risk of premature birth, your attending physician may recommend one or more of the following measures:
- Follow-up ultrasound examination along the cervix from week 16. A cervix shorter than 25 mm is a warning sign
- Fetal fibronectin (fFN) test from the vagina or cervix
- Progesterone hormone treatment as daily vaginal tablets or weekly injections.
- Cervical suture - cerclage
- Using a pessary - a silicone device inserted into the vagina around the cervix
- Medicines to suppress labor called tocolytic drugs and are designed to delay labor for at least 48 hours
- At the same time, treatment with steroids that accelerate fetal lung maturation and reduce the chance of cerebral hemorrhages in the fetus
Due to the higher risk of miscarriage among women who have given birth prematurely, the recommendation is to enter the following pregnancy in a planned manner:
- Use contraception until you are ready to get pregnant again
- Keep an interval of 18 months from the last birth until the next pregnancy
- I arrived in optimal health with balanced chronic diseases such as hypertension, diabetes and thyroid function
- Carry out an orderly pregnancy follow-up in order to detect as early as possible risk factors that can be treated such as: cervical shortening, vaginal inflammations and infections
- Avoid smoking
- Avoid drinking alcohol and using non-medical drugs
- Find the right balance at work and at home and reduce estrogenic factors
- Get help if your partner is violent towards you
- Keep adequate rest. Pregnant women should sleep 8 hours a night.
- Avoid intensive work, carrying heavy objects or actions that require a lot of effort
by Dr. David Shasher, gynecologist and CEO of Fergentech
Fergantec Home – PregnanTech Develops an innovative device to delay premature birth. The device, called Lyons, is currently in a clinical trial among pregnant women at risk of premature birth and is being conducted at the Hadassah Jerusalem, Sheba Tel Hashomer, Kaplan Rehovot and Meir Kfar-Saba medical centers. For details and registration: https://bit.ly/3otz9hn