Q&A: I have had three preterm labor pregnancies and worry about the risk of it happening again.

by Dr. Gerard M. DiLeo

I am currently 27 weeks pregnant with my fourth child. With my previous three, I had preterm labor and diliation, which resulted in bedrest and medication (Terbutaline).

I started having contractions with this pregnancy last week, and went in to be examined. I was found to be 1cm dilated and "soft." The doctor ordered an ultrasound on my cervix and told me based on that, I was not at any higher risk for preterm labor and could resume full activity.

I am still having 2 to 3 contractions per hour and I am very worried. My babies have come progressively earlier, from 37 weeks (#1) to 36 weeks (#2) to 35 weeks and 4 days (#3). Should I get a second opinion?

Usually the people who have disastrous preterm labor have histories of delivering previously at 26, 27, 30 weeks or so. But I agree that your trend isn't reassuring. (Even a 34 week baby can require oxygen and be at slightly higer risks of complications.) What your doctor is doing is employing the latest thinking on determining risk based on ultrasonic shape of the cervix. This means that he or she seems to be on top of things. If you want further peace of mind, ask for an opinion from an maternal-fetal medicine specialist. This will not only back him (her) up but reassure you.

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