Preterm Labor

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If you have any of these symptons, please contact your doctor immediately!

If a baby is born before 37 weeks gestation, or weighs less than about five pounds, he or she is considered premature. The single greatest risk factor for preterm labor is a history of preterm labor.

Factors commonly associated with preterm labor between 20 and 37 weeks can be divided into maternal factors and fetal factors.

Maternal risk factors include:


Infection (urinary tract, amnionitis, systemic, sexually transmitted)
Uterine anomalies, fibroids, retained IUD
Cervical abnormalities: short or funnel shaped
Overdistended uterus: polyhydramnios (too much fluid), multifetal gestation
Rupture of membranes
Uterine bleeding: abruption, previa
Substance abuse: cocaine, amphetamine, smoking
Fetal risk factors include:


Congenital anomalies
Intrauterine death
Multifetal gestation
Signs and symptoms to watch for would be related to these risk factors:


Discharge. If you notice any clear fluid discharge, or any abnormal or malodorous discharge, you should notify your care provider immediately.

STDs or Beta Strep. If you have ever been diagnosed with a sexually transmitted disease or with group B beta strep, your care provider may wish to do typical cultures at your initial visit and then repeat them later in the pregnancy.

Changed pattern of movement. If your baby changes his or her pattern of movement, you should also alert your doctor or midwife.

Multiple gestation. If you have been diagnosed with twins or any higher order gestation, or if ultrasound has detected a "greater than average" volume of amniotic fluid, you should be alert for symptoms of premature labor.

Uterine abnormality or placental problem. If ultrasound has ever detected a uterine abnormality or fibroid -- or if you have experienced a premature separation of the placenta or have a low lying placenta -- you are at higher risk for preterm labor and need to be alert for signs and symptoms.
Symptoms can include, but are not limited to:


Pressure in the pelvis or vagina, or a sense that the baby has "dropped" prior to 36 weeks.

Tightenings or contractions that seem to occur at more or less regular intervals (more than four to five per hour).

Pain that comes and goes, whether it occurs in the lower abdomen or in the back.

Any fluid loss or spotting.
It is important to keep well-hydrated to both prevent uterine irritability and to prevent urinary tract infections that can lead to preterm labor. When my clients feel that things are "not quite right," I have them come in so that they can be checked. Diagnosed early, premature labor can be stopped and the pregnancy can be carried to term.