For years we were taught that women who are at risk for preterm birth should be placed on bed rest, but the trend seems to be changing.
At the 33rd Annual Meeting of Society for Maternal Medicine, Dr. William Grobman, a maternal fetal medicine specialist at the Northwestern Memorial Hospital in Chicago reported findings that might change the landscape of how high risk pregnant women are managed in the future.
Dr. Grobman described a study that involved 646 first-time pregnant women who had a short cervix. These women were placed on an activity restriction (including bed rest) although they had no symptoms of preterm contractions. He reported that there is no scientific evidence that proves bed rest is helpful for women who do not have symptoms although this is a fairly routine practice. When women who were not on bed rest were compared with those who were, the women on bed rest had a double risk of giving birth before 37 weeks. As a clinician, I admit being shocked by this news; but on second thought, maybe not. Unless a woman shows s signs of early labor such as back pain, bleeding, abdominal pain that doesn’t go away after 30 minutes, according to Grobman, what is the benefit of confining her to bed?
Dr. Grobman contends that bed rest for women who don’t have symptoms could actually be harmful because of the increased risk of bone loss. He is, however, careful to state that the women studied were part of a research project that used progesterone to reduce preterm birth and that his findings only applied to women that were not having symptoms. In his study, three-fourths of the women with a short cervix did not deliver early and women who received prenatal care were in a better position to have preterm contractions detected early.
So, if you’re a pregnant woman with a short cervix, should you have bed rest? Yes, if you’re having contractions, bleeding or back pain, especially if you’ve had a previous history of preterm birth. If this is your first pregnancy and you have short cervix – ask for a maternal fetal medicine consult.
Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.