Preterm Labor

More then 6 contractions in an hour before 37 weeks needs to be addressed. There are behavioral treatments as well as medications that can help treat preterm labor.

Deliveries before 37 weeks are considered preterm. If you start to go into labor before 37 weeks that would be considered preterm labor. The closer to 37 weeks you are, the less dangerous delivery would be and therefore the less aggressive the doctor will be in trying to stop contractions.

The uterus is a muscle and contractions are tightening of the muscle of the uterus. Contractions usually last 30-45 seconds. It is normal to have occasional random contractions from the late second trimester all the way until term. These random contractions are called Braxton Hicks contractions and are not dangerous. Braxton Hicks contractions are often not painful but occasionally may be. What distinguishes Braxton Hicks contractions from preterm labor  is that Braxton Hicks contractions do not come regularly.

If you are preterm and experience 6 or more contractions in one hour, you should drink some fluid and lie down. If, in the second hour, you still feel more then 6 contractions you should be seen right away by your doctor or in Labor and delivery. Other warning signs are contractions with vaginal bleeding or a change in discharge.

Preterm labor can often be successfully stopped if it is caught early in the process. If dehydration is the cause then drinking fluids or, if necessary, receiving fluids through an IV can help stop the contractions. Sometimes an infection can be the underlying cause, a urine infection is a common cause of preterm contractions. Treating the infection can stop the contractions. Most of the time the underlying cause of preterm labor is not identified.

Bed rest is often prescribed for preterm labor. This may be complete bed rest and may require hospitalization or “modified” bed rest that can be done at home. Pelvic rest is also commonly prescribed. Pelvic rest means nothing in the vagina, no sex, tampons, etc.

There are several medications that are used for the treatment of preterm labor. Terbutaline, Magnesium Sulfate, and Nifedipine are among the most common medications for preterm labor.

Terbutaline is a medication that can be given orally, as an injection, or in the IV. It is often used as an injection at the beginning of the treatment. Sometimes one shot of Terbutaline is enough to stop the contractions. Terbutaline is very safe in pregnancy. The biggest side effect of terbutaine is causing a rapid heartbeat in the pregnant woman. This rapid heartbeat goes away in a few minutes.

Magnesium Sulfate is a medication that is given through an IV. If you require Magnesium Sulfate, you will need to be hospitalized while it is given. It is generally given as a continuous IV but in some instances can be given as a shot. Magnesium Sulfate has a narrow therapeutic window, this means that the blood level required to be effective is close to the blood level that is considered toxic. For this reason Blood levels are generally checked fairly often and the dose adjusted ans necessary. Magnesium Sulfate can have a lot of side effects including nausea, weakness, tiredness, and a general poor feeling.

Nifedipine is a medication that is primarily used to lower people’s blood pressure. It can also help stop contractions. Nifedipine is most commonly given orally as a pill. The biggest side effect is the tendency to lower blood pressure. If you are starting with normal or low blood pressure this can be significant. This is a medication that can be used at home after the initial preterm labor is controlled.

Betamthethasone is a steroid injection that can be given between 24 and 34 weeks to hasten the baby’s lung development in a situation where there is concern that the baby may deliver early. It is given as a shot, usually two doses either 12 or 24 hours apart.