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Understanding Preterm Labor and Birth -- Diagnosis and Treatment

How Do I Know If I'm Experiencing Preterm Labor?

If you go to your health care provider 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 will 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 will take a small sample of fluid to determine whether it is truly amniotic fluid. If it is, a sample may be sent to a lab to determine how mature your baby's lungs are. Or your doctor may choose to perform an amniocentesis, which can provide information about your baby's lung development.

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Your practitioner will want to test your urine for infection. You may be asked to provide a urine specimen, 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, such as the presence of group B streptococcal bacteria.

What Are the Treatments for Preterm Labor?

If you are at risk, from a previous preterm birth, your health care provider may want you to start taking a progesterone drug, such as Makena, to help you to carry your baby closer to term.

If you get to the hospital early in labor, your practitioner may be able to stop labor from progressing with hydration, bed rest, and muscle relaxants or other drugs, which may require hospitalization. The intent is to hold off labor to allow the baby's lungs and other organs more time to develop and reach maturity. If doctors can prevent delivery for even a little while, the mother can be given steroids to speed up the baby's lung development.

If your health care provider determines that you are in preterm labor, you will likely be admitted to the hospital. You'll probably be treated with one of several drugs, called tocolytics, to try to stop the contractions. You also may be given an antibiotic as a preventive measure, even if you have no obvious infection, and steroid medications to speed up your baby's lung development.

If your contractions are successfully stopped, you may be sent home from the hospital, sometimes with an oral drug. You'll probably be asked to decrease your activity level, or even to stay on bed rest, until you get closer to your due date.

In other cases, your doctor may advise you 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 illnesses such as severe preeclampsia or eclampsia (high blood pressure that occurs during pregnancy).

Delivering the baby prematurely may also be preferable if evaluation shows that the fetus 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 identified.

WebMD Medical Reference

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