Chances of Another Preterm Birth?

I am 35 weeks pregnant with my second child. My first child was born five weeks early, after rupture of the membranes and five hours of labor. I had just seen my doctor that day, and apparently my cervix was completely closed and not effaced, so I had no warning. What effect does this history have on my current pregnancy?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Every day that you go beyond 35 weeks benefits your baby, and it is very normal to come to this same stage and think about another preterm birth. Rupture of membranes can be an unexplained event that leads to labor, but in some women it can be traced to a vaginal infection or sexually transmitted disease such as bacterial vaginosis, chlamydia, gonorrhea or trichomoniasis. All women should be tested for these during the pregnancy, so women at risk can be treated.

This may not happen again, and it is very reassuring that you have made it this far. One thing occurs to me, however. You dilated rather rapidly with your first, and if you had written this letter at 20 to 30 weeks, I would have advised you that you may be at risk for incompetent cervix. But if you can hold a pregnancy until 35 weeks, this could not be a problem. You may, however, be prone to precipitous labors, so do not wait the typical time at home with this baby before going to the hospital. You may decide to go as soon as you start regular contractions.

Of course, let your provider know if you have any leaking or rupture of fluid, and let him/her tell you when you need to come in; it sounds like it would be a good idea to come a little earlier and to have your cervix checked at your next visit for early cervical changes.

I wish you well and best of luck.

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