Understanding Preterm Labor and Birth -- Diagnosis and Treatment
How Do I Know If I'm Having Preterm Labor?
If you go to your doctor or a hospital because you think you may be in preterm labor, monitors will be placed on your abdomen to measure your baby's heart rate and record any uterine contractions that you have. The doctor may do a pelvic exam to see if your cervix is dilating.
If you think your water has broken or if the doctor sees any fluid coming from the cervix, he or she may take a sample of the fluid to see if it is amniotic fluid. If it is, a sample may be sent to a lab to determine how mature your baby's lungs are. If you are near 36 weeks pregnant, the doctor may do an amniocentesis, which can provide information about your baby's lung development.
Your doctor will want to test your urine for infection. You may be asked to provide a urine sample, or your practitioner may put a tiny tube in your bladder, called a catheter, to remove a urine sample. Swabs of your cervix may be sent to a lab to test for infection.
A swab may be obtained to perform a fetal fibronectin test (FFN), a test that can be used to predict preterm labor. This test is done like a Pap smear, and while it can't tell you for sure that you are in labor, it can tell you if you're not. A woman at risk for preterm delivery can be told what to do if symptoms occur, and may get more tests.
What Are the Treatments for Preterm Labor?
If you have had a preterm birth before, your doctor may want you to start taking a progesterone drug for prevention to help you carry your baby closer to term.
If you get to the hospital early in labor, your doctor may be able to stop labor with hydration, bed rest, and muscle relaxants or other drugs, which may require hospitalization.
If your doctor decides that you are in preterm labor, you will probably be admitted to the hospital. You may be treated with one of several drugs, called tocolytics, to try to stop the contractions. This will help hold off labor to allow the baby's lungs and other organs more time to develop. If doctors can prevent delivery for even a little while, the mother can be given steroids to speed up the baby's lung development. You also may be given an antibiotic as a preventive measure, even if you have no obvious infection.
If your contractions are stopped, you may be sent home from the hospital. You'll probably be asked to rest a lot or even to stay on bed rest until you get closer to your due date.
In other cases, your doctor may choose to deliver the baby early, rather than trying to stop labor. This choice is usually made when the mother is suffering from an infection of the amniotic fluid and uterus or has an illness such as severe preeclampsia or eclampsia (high blood pressure that occurs during pregnancy).
Delivering the baby prematurely may also be done if the baby is not doing well, if you have placenta previa (a placenta covering the cervix) that bleeds a lot, if you have placental abruption (detachment of the placenta), or if certain birth defects or malformations are found.