Q: I am a 32 years old female, mother of a five years old boy. During my second pregnancy, I had severe pain in fifth month; following which the membranes ruptured and I had to undergo an abortion. I was under hormonal treatment till my third month of pregnancy. I would like to know what causes pain and uterine contractions before term and how can I overcome these during my next pregnancy?

A:You would need to have tests to find the cause of the late abortion, which could most likely be due to an early opening of the mouth of the uterus, which can be treated in the next pregnancy by putting a stitch to close the cervix, in the 14th week of pregnancy. Other causes of abortion could be an infection, uterine or urinary, or TORCH infections or endocrine problems like thyroid or diabetes, which all need to be excluded and treated depending upon the cause. A more detailed history and tests are needed before planning the next pregnancy.