The Story Began: Preemies, Prevention and Progesterone (17P): My First Preemie
Having a first pregnancy end in preterm labor was terrifying, and now being pregnant again is anxiety-producing. Our preemie-son, now three years old, is healthy and doing great, but what is in store for this second pregnancy? We wanted another child, and tried for well-over six months, but now I feel this impending doom about my undeniable future labor and delivery.
Can I handle another premature labor? Can I handle another preemie baby? What if we have another preemie who is born at an even earlier gestational age, with even more potential for severe long-term health complications? Are we strong enough to handle this risk? I wanted to know: is there a way I can prevent another preterm labor? I felt as if I had no ground to start from, as I was told I had none of the risk factors for a first preterm labor (hence, nothing to change or “fix”), and even worse is that I now do have a huge risk factor that I can do absolutely nothing about: a previous preterm labor.
The reason for my preterm labor is unknown, as the cause was undeterminable. However, since my water did break (the medical community calls this “ruptured membranes”), my situation was called PROM (premature spontaneous rupture of membranes). Unfortunately, the cause of my PROM is, you guessed it, unknown.
As many of you know, this is the most frustrating diagnosis: a condition without a known cause. How can I prevent something if I don't even know what I am trying to prevent or guard against?! How can I fix it if no one knows what exactly is broken?
The statistics report premature births are on the rise over the past twenty years, and in the United States, almost 13 percent of babies are born prematurely. It is important to know this statistic only paints part of the picture, as a large majority (70 percent) of those babies born prematurely are born between 34-36 weeks gestation (“late-preterm babies”) and fortunately, have little long-term health consequences from their early arrival. Babies born after 37 weeks are considered full-term. As for the rest of the babies born prematurely, 12 percent are born between 32 and 33 weeks, 10 percent between 28 and 31 weeks, and 6 percent at less than 28 weeks gestation. [Source: March of Dimes]
According to the statistics above, my preterm labor was in the 12 percent category of premature babies born between 32 to 33 weeks. Hence my anxieties and fears with a second pregnancy, as babies born before the 34th week of gestation can suffer from breathing problems referred to as respiratory distress syndrome (RDS), and I wanted to learn how to prevent this complication, as well as any other preventable causes of preterm labor.
I began searching for information on how to prevent recurring preterm labor, and spoke with my OB/GYN. Fortunately, there is a preventative measure that is relatively inexpensive and manageable, called 17P injections (17 Alpha-Hydroxyprogesterone Caproate).
The next step, now armed with hope and a prevention option, is to review the medical literature and current studies, as I needed to know how safe and effective this treatment is. What are the possible side effects and risks involved for me and my baby? In my next story, I share the findings from the literature, as well as the answers regarding the safety concerns.
Next article in series, Preemies, Prevention and Progesterone (17P): Review of the Medical Literature