I had preterm labor before. How can I avoid it next time?

Hello,

Welcome to icliniq.com.

I understand your concern.

Thanks for your question. Since you have had a preterm delivery in the past, it is a very valid concern to try to prevent it from happening again in your next pregnancy. Good that you are thinking about this even before conceiving, that helps.

Your first baby being born at 32 weeks could have been due to various reasons, like infections, a short cervix, uterine abnormalities, hormonal issues, stress, or just an unexplained spontaneous labor. Even things like thyroid imbalance or poorly controlled sugar levels can play a role.

Before planning the next pregnancy, it is wise to:

1. Get a pelvic ultrasound or scan to rule out uterine issues (like fibroids or anomalies).

2. Get your thyroid profile and sugar levels checked. You might also ask your gynecologist for a cervical assessment (especially if your cervix was short last time or opened early).

3. Pap smear or vaginal swab if infection was suspected earlier.

It can also be due to other conditions like:

1. Cervical insufficiency.

2. Undetected genital infections.

3. Hormonal imbalance.

4. Uterine structural issues.

5. Stress-related triggers

The probable diagnosis is previous spontaneous preterm labor with an unclear cause. At this stage, before pregnancy, your focus should be on:

1. Starting Folic acid tablets daily (400 to 600 mcg (micrograms)).

2. Keeping weight healthy (your BMI (body mass index) seems fine right now).

3. Treating any infections if found.

4. Discuss with your doctor the need for cervical length monitoring during early pregnancy.

5. If cervical weakness is suspected, a cervical stitch (cerclage) might be discussed in the next pregnancy.

6. In some women with a past preterm birth, progesterone supplements are started during pregnancy, usually from 16 to 36 weeks.

7. Avoid heavy physical stress or travel in the early months.

8. Plan regular antenatal check-ups right from early pregnancy.

9. Control thyroid/sugar if any imbalance is present.

10. Maintain a healthy diet and avoid junk food or stress.

11. Try not to space long gaps between pregnancies.

12. Avoid smoking or second-hand smoke (if applicable).

Once you conceive, do get in touch with your gynecologist early. Also, share your past delivery details fully; sometimes your discharge papers help understand the exact cause better. You can always follow up here, too, if you get any reports done. I will guide you accordingly.

I hope this helps.

Thank you.