Preterm birth rates continue to rise in the United States and are a major cause of neonatal morbidity and mortality. Low-dose aspirin has been researched as a possible inexpensive and safe medication to help reduce the incidence of preterm birth.
Aspirin helps by reducing uterine contractility and inflammation. Many medical issues such as the fetus being too small for gestational age, preeclampsia, placental insufficiency, and spontaneous labor may be reasons to consider protocols to help prevent preterm births. In these instances, the effects of aspirin may be very helpful.
Many studies have shown a decrease in preterm births in patients taking low-dose aspirin prior to and during pregnancy. It can be especially helpful to those with a history of a previous pregnancy loss.
The possibility of decreasing the incidence of preterm labor is very exciting. Additional research is necessary to fully observe and understand all of the effects of low-dose aspirin on pregnancy. Always remember to speak to your health care provider to discuss your particular concerns and to see if low-dose aspirin can be beneficial to you!
We all know that cigarette smoking is a health hazard. In pregnancy, smoking spreads that hazard to the baby as well as the mom. The CDC (Centers for Disease Control and Prevention) provides us with the following information:
It is reported that 10% of women smoke during the last 3 months of pregnancy
50% of women who smoke before a pregnancy will quit during the pregnancy
50% of women who stopped smoking during a pregnancy will go back to smoking after their baby is born
Smoking increases the difficulty to become pregnant
Smoking increases the risk of spontaneous miscarriages
Smoking also increases the risk of a premature birth
This action increases nicotine and decreases oxygen to the developing fetus
The baby’s placenta may not work as well in mothers who smoke
Smoking increases the risk of certain birth defects, including cleft lip and cleft palate
If you smoke, please try to stop for your health and the health of your baby.
About 5% of all women have a uterine fibroid and this is the most common of the noncancerous gynecological tumors. Since fibroids can increase risks during a pregnancy, the health care provider follows a pregnant woman with fibroids carefully.
One of the complications can be that the baby is in a position other than head-down near the time of delivery. This can affect the type of delivery advised. Other possible complications associated with fibroids and pregnancy can be pain, preterm delivery, premature rupture of the membranes, and other difficulties.
Because of the great hormonal changes during pregnancy, fibroids can shrink or grow at this time. The changes occur mostly in the first 3 months of the pregnancy. More pregnancy complications have been found when a fibroid is larger than 10 cm.
If you have fibroids and are pregnant, start early discussions with your health care providers about the risks to be concerned about and how is the best way to be followed during your pregnancy.
Over the past 50 years, more women are delaying childbirth for many reasons. Now obstetrical teams are seeing an increase in first births for women aged 40 to 44. Pregnancies can progress beautifully with these women but increased risks have been associated with later motherhood. Some of these risks include:
Abnormal fetal chromosomes
Diabetes during the pregnancy
High blood pressure before and during the pregnancy
Preterm labor and delivery
Increased chance of twins
The age of the father is also of concern here. Advanced paternal age is often thought of as being 40 or older at the time of conception. There are studies suggesting that advanced paternal age can be associated with a higher risk for autism spectrum disorders and some gene abnormalities.
If you or your partner is in this age group and are considering a pregnancy, begin a discussion with your health care provider.
Preterm births continue to be a large problem in the United States, leading to many problems for these children. It is the leading cause of infant mortality in our country. Prevention is always the goal, and today, measuring the cervical length with a transvaginal sonogram may help identify patients who are at a higher risk for preterm births.
Once identified, these patients may benefit from close follow-up plus the progesterone treatments and cervical surgery that are available. Here are some more details:
The cervix may begin to shorten long before preterm labor or before the preterm rupture of membranes occur.
The cervical length usually can be measured with the use of a transvaginal sonogram.
A shortened cervix found before 20 weeks of pregnancy markedly increases the risk of preterm birth. Progesterone treatments and cervical surgery, called a cerclage, may reduce the risk significantly.
Women with a history of a preterm birth, multiple gestations, or a previous cervical surgery are at a higher risk of early delivery and so may benefit from cervical length measurements.
As always, a dialogue with your health care provider is the first step in receiving the best medical care. For the prevention of a preterm birth, taking the measurement of the cervical length may be part of that discussion.
When a pregnant woman “breaks her water” usually it is the start of an exciting time of her pregnancy because labor has started or is about to begin. This is fine if the pregnancy is near the due date, but if the water breaks and the pregnancy is not near the due date, then there is a problem. Preterm premature rupture of membranes (PPROM) is a bad problem and is a leading factor in premature births.
About 12% of births in the US are preterm
Most pregnancies last about 40 weeks
Babies born between 32 and 37 weeks are considered preterm, and babies born before 32 weeks are considered early preterm
About 5% of births in the US are complicated by PPROM
Since the most common outcome of PPROM is delivery of the baby within 1 week of the water breaking, information about this potential complication must be available to everyone.