Treatments for preterm labor

Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend some treatments that may help stop your contractions and prevent health problems in you and your baby. 

These treatments are not a guarantee to stop preterm labor. But if you’re having preterm labor, they may help you stay pregnant longer. Talk to your provider to find out if these treatments are right for you.

What kinds of medicines are used during preterm labor?

There are three kinds of medicines your provider may give you if you’re having preterm labor:

  1. Antenatal corticosteroids (also called ACS). These speed up your baby’s lung development. They also help reduce your baby’s chances of having certain health problems after birth, including respiratory distress syndrome (also called RDS), intraventricular hemorrhage (also called IVH) and necrotizing enterocolitis (also called NEC). RDS is a condition that affects a baby's breathing. IVH is bleeding in the brain. NEC is a condition that affects a baby's intestines.
  2. Antibiotics. These kill infections caused by bacteria. You may need antibiotics to help prevent infections in you and your baby if you have Group B strep infection or if you have preterm premature rupture of membranes (also called PPROM). PPROM is when the sac around your baby breaks before 37 weeks of pregnancy. 
  3. Tocolytics. These slow or stop labor contractions. Tocolytics may delay labor, often for just a few days. This delay may give you time to get treatment with ACS or to get to a hospital with a neonatal intensive care unit (also called a NICU). This is the nursery in a hospital where newborns get medical care. One kind of tocolytic called magnesium sulfate shouldn’t be used for more than 5 to 7 days. Using this medicine for a longer time may lead to low levels of calcium and bone problems in your baby. And if you have a health condition, like a heart problem or severe preeclampsia, some tocolytics may not be safe for you. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache.

Are there other kinds of treatments for preterm labor?

Yes. Your provider may recommend these treatments:

  • Progesterone. This is a hormone that plays a key role during pregnancy. Treatment with progesterone may help prevent premature birth for certain women. Talk to your provider to see if progesterone treatment may be right for you. 
  • Cerclage. This is a stitch that your provider puts in your cervix. The stitch may help keep your cervix closed so that your baby isn’t born too early. Your provider removes the stich at about 37 weeks of pregnancy. A cerclage is only used for certain women. For example, your provider may recommend a cerclage if you have a short cervix. Talk to your provider to see if a cerclage may be right for you. 
  • Bed rest. Providers don’t know if bed rest can help you stay pregnant longer, even if you have signs of preterm labor. Bed rest means that you take it easy until your baby’s born and stay calm and still. Your provider may want you to rest just a few times each day. Or she may want you to stay in bed all day.

Do medicines used during preterm labor have side effects for mom and baby?

Sometimes. A side effect is an effect of a drug or medicine that is not the intended result. For example, a side effect of some cold medicines is that they make you sleepy. Medicines used to during preterm labor may do what they’re supposed to do to help you or your baby, but they may have side effects, too. Side effects can be different for every woman and depend on the kind of medicine you get. Talk to your provider about what kind of medicine is right for you.

  • Antenatal corticosteroids, including betamethasone and dexamethasone. Possible side effects for mom for both of these medicines may include fluid build-up in the body and increased blood pressure. There are no side effects for your baby. 
  • Tocolytics. Several kinds of tocolytics may be used during preterm labor, each with different side effects.
    • Beta-adrenergic receptor agonists, like terbutaline. Possible side effects for your baby may include having a fast heartbeat. Possible side effects for you may include:

      • Chest pain; fast or irregular heartbeat
      • Breathing trouble; fluid in the lungs
      • Diarrhea, nausea (feeling sick to your stomach), throwing up
      • Feeling dizzy; shaking or feeling nervous; seizures
      • Fever, headache
      • High blood sugar
      • Low blood pressure; low blood potassium 
    • Calcium channel blockers, like nifedipine. There are no side effects for your baby. Possible side effects for you may include: 
      • Constipation, diarrhea, nausea
      • Feeling dizzy or faint
      • Headache
      • Low blood pressure
      • Redness of the skin
    • Magnesium sulfate. Side effects for your baby may include:
      • Being tired and drowsy
      • Slowed breathing
      • Weak muscles
      • Low levels of calcium and bone problems, if the drug is used for more than 5 to 7 days. Side effects for you may include: 
      • Breathing problems, fluid in the lungs
      • Dry mouth
      • Fatigue (being very tired), weak muscles
      • Headache, double vision, slurred speech
      • Heart attack
      • Nausea or throwing up
      • Redness of the skin, heavy sweating
    • Nonsteroidal anti-inflammatory drugs (also called NSAIDs), like indomethacin. Side effects for your baby may include: 
      • Bleeding in the brain or heart
      • Patent ductus arteriosis, also called PDA. This is a heart problem that’s common in premature babies. 
      • Jaundice. This is a common condition caused by the build-up of a substance called bilirubin in the blood that makes a baby’s skin and the white parts of his eyes look yellow.
      • Kidney problems, like making too little urine
      • Necrotizing enterocolitis (also called NEC). This is a problem in a baby’s intestines.
      • Rising blood pressure in the lungs

Side effects for you may include:

Last reviewed: July, 2014