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Preterm Labor

AMBULATORY CARE:

Preterm (premature) labor

occurs when the uterus contracts and your cervix opens earlier than normal. The cervix is the opening of your uterus. Preterm labor happens after the 20th week of pregnancy but before the 37th week. You may have premature rupture of membranes (PROM). PROM means your water broke before labor began. An early labor could cause you to have your baby before he or she is ready to be born.

Female Reproductive System

Common signs and symptoms include the following:

You may not know that you are having preterm labor. It is common to have preterm contractions (tightening and relaxing of the uterus) and not notice them. The following are signs and symptoms that suggest a preterm labor:

  • Contractions that get stronger and closer together
  • Changes in vaginal discharge, such as more discharge or discharge that is watery or bloody
  • Low back pain
  • Pressure in the lower abdomen
  • Vaginal spotting or bleeding

Call your local emergency number (911 in the US) if:

  • You see or feel like there is something in your vagina.

Call your doctor if:

  • You have bright red, painless vaginal bleeding.
  • Your symptoms do not get better or they get worse.
  • Your water broke or you feel warm water gushing or trickling from your vagina.
  • You have contractions that get stronger and closer together for more than 1 hour.
  • You notice a decrease in your baby's movement.
  • You have abdominal cramps, pressure, or tightening.
  • You have a change in vaginal discharge.
  • You have a fever.
  • You have burning when you urinate or you are urinating less than is normal for you.
  • You have questions or concerns about your condition or care.

How preterm labor is diagnosed:

You may have one or more of the following tests to check for preterm labor:

  • A pelvic exam is also called an internal or vaginal exam. During a pelvic exam, your healthcare provider will gently put a warmed speculum into your vagina. A speculum is a tool that opens your vagina. This lets your healthcare provider see if your cervix is opening.
  • A vaginal ultrasound uses sound waves to show pictures of your cervix and your baby inside your uterus. During this test, a small tube is placed into your vagina. This test will help your healthcare provider see if your cervix is opening.
  • A fetal ultrasound uses sound waves to show pictures of your baby inside your uterus. The movement, heart rate, and position of your baby can also be seen.
    Pregnancy Ultrasound
  • A fetal fibronectin test checks for a protein called fetal fibronectin in the cervix or vagina. Normally, there is no protein in cervical and vaginal secretions until the 20th week of pregnancy up to the end of pregnancy.
  • Blood and urine tests may be done to look for signs of infection.

Treatment for preterm labor

may delay delivery. You may need any of the following:

  • Bed rest may be recommended. You may need to lie on your left side, which improves circulation to the uterus and baby. Your healthcare provider will tell you when it is okay to get out of bed.
  • Medicine may be given to stop contractions if your baby is not ready to be born. You may also need certain medicines if your preterm labor cannot be stopped and your healthcare provider thinks you will have your baby early. These medicines help your baby's lungs, brain, and digestive organs mature. They also help decrease your baby's risk of being born with cerebral palsy. If you have PROM, fluid from your vagina or rectum will be checked for a strep infection. You may be given antibiotics to prevent a strep infection during delivery. Antibiotics may also be used to prevent labor from starting. You may also need steroids to decrease the risk for complications due to preterm labor.

Self-care:

  • Rest as much as possible. You may need to lie on your left side to improve circulation to the uterus and baby. You may be able to prevent preterm labor by resting and reducing your physical activity.
  • Ask your healthcare provider about activities that are safe for you to do. Your healthcare provider or obstetrician may recommend that you avoid sexual intercourse. Ask your healthcare provider if exercise is safe.
  • Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you.
  • Do not smoke. Your baby may not grow well and he or she may weigh less at birth if you smoke during pregnancy. Smoking also increases the risk that your baby will be born too early. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Do not drink alcohol. Alcohol may harm your unborn baby and cause preterm labor.
  • Maintain a healthy weight. A healthy weight may prevent preterm labor. Ask your healthcare provider how much weight you should gain during your pregnancy.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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Further information

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