Many women will experience some signs of preterm labor during pregnancy, and I thought it would help to write some signs to help you decide between what is "false" labor from what is real. If you are having occasional contractions such as a few per day, this is usually nothing to worry about. However, if you feel that you are starting to have a pattern to the contractions such as 3 or more contractions per hour for more than hour you should be checked. Other signs of preterm labor include cramping (feeling like menstrual like cramps), pressure in the vagina or rectum, increase in vaginal discharge, leaking amniotic fluid, or backache, then you should be evaluated by your practitioner.
Typically, when patients present with signs of preterm labor, we run a test call a fetal fibronectin which we obtain from a vaginal swab. If this test is negative, there is a 99% chance you will not deliver for at least 2 weeks. Thus, this test is very indicative. However, if it is positive, you won't necessarily deliver early, but we will be more aggressive in our treatment to prevent preterm birth. Treatment is usually aimed at stopping contractions and thus slowing cervical dilation, and at buying more time for fetal maturity. We stop contractions with medications, and bed rest, as well as hydration. We also give you injections (steroids) to aid in fetal lung maturity in the event that your baby is born early. If you have had a history of preterm labor or preterm birth (preterm being less than 37 weeks gestation) we also may start you on progestone shots at about 17 weeks until 36 weeks. Although this doesn't always prevent preterm birth, there is some good evidence that it may delay it and allow more time for fetal maturity.
So, bottom line, make sure you tell me or your practitioner if you are noticing signs of preterm birth or if you have a history of preterm birth....hopefully we can have a better outcome than before!