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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 examination to check 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 in order to determine whether it is truly amniotic fluid. If it is, a sample may be sent to a laboratory to determine how mature your baby's lungs are.

Alternatively, your doctor may choose to perform an amniocentesis, which can provide information about your baby's lung development.

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 (catheter) to remove a urine sample. Swabs of your cervix may be sent to a laboratory to test for infection, such as the presence of group B streptococcal bacteria.

What Are the Treatments?

If you get to the hospital early in labor, your practitioner may be able to stop labor from progressing with hydration, bed rest, muscle relaxants or other drugs, possibly requiring hospitalization. The intent is to hold off labor to allow the baby's lungs and other organs more time to develop and reach maturity. Furthermore, 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 may be admitted to the hospital. You'll probably be given intravenous fluids (through a needle in your arm). You will likely be treated with one of several drugs (called tocolytics) to try to stop the contractions. The names of these drugs are calcium channel blockers, terbutaline, ritodrine, magnesium sulfate, indomethacin, ketoralac and sulindac. You are often given an antibiotic prophylactically, even if you have no obvious infection. Also, you'll usually be given 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 medication. You'll probably be asked to decrease your activity level, or even to stay on bedrest, until you get closer to your due date.

Sometimes when you are in premature labor, your doctor may choose to allow 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 (forms of high blood pressure that occur during pregnancy).

Delivering the baby prematurely may also be preferable if evaluation shows that the fetus is not doing well, if there is placenta previa (placenta covering the cervix) that bleeds a lot, if there is placental abruption (detachment of the placenta) or if certain birth defects or malformations are identified.