The threat of premature labor shouldn't cause panic. The majority of
preterm babies are delivered between 34 and 36 weeks, and most of them are
healthy and need little or no special care after birth.
If a baby is born before 32 weeks, however, the prognosis is less
optimistic. Read these frequently asked questions about what to do if you
suspect you're in premature labor.
Am I really in labor?
After about 30 weeks of pregnancy, many women notice occasional uterine
contractions. Called Braxton Hicks contractions, they're normal and usually
painless. They tend to occur when you're tired or have just had physical
activity, and they usually stop when you rest. True labor contractions come
at regular intervals or progressively become more frequent or more painful;
Braxton Hicks contractions don't.
You are considered to be in preterm labor when you have uterine
contractions every ten minutes (or more often) as well as cervical changes
(dilation, thinning, softening) prior to 37 weeks gestation.
In some cases it can be difficult for even a doctor to determine if a woman
truly is in labor. Your doctor will probably tell you to go to the hospital
(if you're not already there), where you can be monitored carefully.
Some women at high risk for preterm labor are given a belt with
electronic sensors. This is strapped around the abdomen to detect early
contractions. Once or twice a day, the monitor is hooked up to a telephone
so it can relay graphs of uterine activity to a nurse. The goal of home
monitoring is to detect preterm labor early, when it's most treatable.
Two tests, one that measures hormones in the saliva and another that
measures vaginal secretions, can also aid in diagnosing preterm labor. A
vaginal ultrasound, which can accurately assess cervical dilation and other
cervical changes, may help too.
If your doctor determines that you are truly in labor, she will probably
attempt to halt it, unless for some medical reason it's not advisable. (For
instance, if you have very high blood pressure or uterine bleeding due to a
problem with the placenta, or if there's fetal distress such as a slowed
heart rate that could indicate a lack of oxygen.)
How will the doctors try to stop the contractions?
To try to halt your contractions, your doctor will ask you to rest on
your left side (this position increases blood flow to the uterus), and if
you seem dehydrated, she will give you intravenous fluids. These steps help
stop contractions in about 50 percent of women. If your contractions stop
and your cervix doesn't dilate during several hours of observation, you
will probably be able to go home.
If your cervix is dilating, however, your contractions are unlikely to stop
on their own. If you are between 34 and 37 weeks and the baby already is at
least 5 pounds, 8 ounces, the doctor may decide not to delay labor. These
babies are very likely to do well even if they're born early.
Your obstetrician may decide that postponing the birth through medication
is the appropriate course of action. While there is no established "right"
time to start treatment with medication, many doctors recommend beginning
once your cervix becomes two to three centimeters dilated. While drugs
usually don't postpone labor for long (often not more than a couple of
days), sometimes even a short delay can make a lifesaving difference to
your baby.
For example, it gives your doctor time to begin treatment with
corticosteroid drugs aimed at preventing or lessening complications in
preterm newborns. Corticosteroids speed maturation of fetal organs,
reducing infant deaths by about 30 percent and cutting the incidence of the
two most serious complications of preterm birth: respiratory distress
syndrome and bleeding in the brain. They are given by injection and are
most effective when administered at least 24 hours before delivery.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.
Content courtesy of American Baby.