Preterm labor

Background

• Defined as labor before 37 weeks (uterine ctx and cervical change)
• Increased risks to child depending on age of fetus
  • Cerebral palsy, poor lung development, cognitive delay, etc
• Can be triggered by maternal infx, stress, HTN, uncontrolled DM

Clinical Presentation

• Similar to term labor
  • Uterine contractions q 10 min (may be irregular)
  • New onset of vaginal mucus, blood, pink discharge, amniotic fluid
  • Low back ache, vaginal pressure

Differential Diagnosis

• Preterm Labor
• Placental abruption
• Placenta previa
• Vasa previa
• Uterine rupture
• Vaginal trauma

Diagnosis

• Start with ultrasound to assess position of cervix
• Do NOT perform digital exam in patients who present with vaginal bleeding when >20 weeks pregnant