Kristie McNealy, MD

One goal of Blogging for Prematurity Awareness is to educate and empower moms-to-be about the risks of preterm labor and the impacts of prematurity so they can be better advocates for themselves and their baby. With nearly half a million babies being born prematurely in the United States each year, 1 in 8 pregnancies in the US ending in preterm delivery, the warning signs of preterm labor are something every woman should know.

Any delivery before 37 weeks is considered preterm, and prematurity is a serious problem which can lead to life long medical and developmental problems. The good news is that preterm delivery can sometimes be prevented or delayed with prompt medical attention.

The single most common risk factor for premature birth is a previous history of preterm delivery. Women who are pregnant with more than one baby (twins, triplets, etc.), as well as women with certain uterine and cervical abnormalities are also at an increased risk of going into preterm labor (PTL). However, most women who deliver preterm have none of these risk factors, and because of this, it’s important for every woman to be familiar with the possible signs and symptoms of preterm labor.

If you experience any of the following symptoms of possible preterm labor, contact your doctor or midwife immediately:

1. More than 4-5 uterine contractions in an hour
2. New back or abdominal pain
3. Back or abdominal pain which comes and goes rhythmically
4. Menstrual like cramping (my only symptom when I went into PTL with #3 at 32 weeks)
5. Leaking of fluid, bleeding, mucous or change in vaginal discharge
6. Pressure in the pelvis, like the baby is pushing down.

You don’t need to have all of these symptoms to be in preterm labor, and these are certainly not the only symptoms a woman going into preterm labor can experience. If you are ever concerned that something is wrong, it is important that you contact your healthcare provider or go to the hospital right away. Don’t let worry or embarrassment about being wrong keep you from seeing your doctor, because prompt attention could provide vital extra time in the womb for your baby.

If you go to the doctor or hospital because you are concerned you might be in preterm labor, you can expect to have some (or all) of the following tests and exams:

1. Uterine monitoring to check for and document any contractions
2. An ultrasound to check amniotic fluid levels (AFI), the baby’s well being (biophysical profile or BPP) and the length of your cervix
3. Fetal fibronectin (fFN) swab to check for chemicals that indicate on increased risk for delivering your baby very soon
4. Internal cervical exam to check for dilation, and to see if your cervix is softening or shortening
5. Check for leaking amniotic fluid.

If your doctor discovers that you are having regular contractions, leaking amniotic fluid, or your cervix is changing, they will try to find out why, as well as trying to stop your labor if it is safe and possible.  Usually this process involves giving IV fluids to make sure you are well hydrated, using medications to try and stop contractions, checking for urinary tract or other infections, and giving you an injection of steroids to help mature the baby’s lungs.

Similar Posts:

• Preterm Labor Facts Every Woman Should Know
• Fetal Fibronectin Test Helps Predict Preterm Birth – Medical Monday
• Saliva Progesterone Levels Could Predict Preterm Labor
• Magnesium Sulfate Reduces Cerebral Palsy in Preemies