How can premature contractions be detected?
Usually a pregnancy lasts 40 weeks. During this time, the body increasingly prepares for the forthcoming delivery, including the uterus. The uterus is an organ that is completely surrounded by a thick, strong muscle layer.
This muscle layer ultimately produces the contractions at the time of birth and enables the expulsion of the child by contracting. In order for this process to be fully mature at the time of delivery, the uterus performs the so-called Braxton-Hicks contractions from about the 20th-25th week of pregnancy. These are exercise contractions, which are a kind of training for the birth.
In most cases, they are relatively painless, of short duration and irregular. Premature contractions are also called ineffective, as they do not affect the opening of the cervix. Most women describe the exercise contractions as short hardening of their abdomen that lasts for about one minute.
Exercise contractions are absolutely harmless and are no cause for concern.A distinction is made between these two types of contractions, which usually occur from the 36th week of pregnancy onwards and represent a kind of dress rehearsal for the birth. Here the pregnant woman feels a violent pulling in the abdomen, which can even radiate into other parts of the body. Many women feel this pulling also in the back or in the groin area.
The abdomen hardens in the same way as during the exercise contractions. Real pain, on the other hand, is rarely felt during a contraction. The intervals at which the premature contractions occur are usually irregular and the pulling is not permanent.
This type of contraction also gives no indication of a possible premature birth; it is completely normal. Subsequently, the so-called sink contractions frequently occur. As the name already suggests, this is the lowering of the child’s head deep into the pelvis.
This process can be classified chronologically around the 36th week of pregnancy. In contrast to the types of contractions described so far, these are painful contractions. But they also have one advantage: because the child is now deeper in the pelvis, it is much easier for the pregnant woman to eat.
These completely normal types of contractions are in contrast to the early contractions that can occur in any part of the pregnancy. Unfortunately, early contractions are not without danger and can mean that the body tries to initiate the birth process prematurely. In principle, they are very similar to the other types of contractions, but they usually occur more frequently and with increasing intensity.
If premature contractions occur more than three times in one hour, and this before the 36th week of pregnancy is completed, it is advisable to contact the gynaecologist or the responsible midwife as soon as possible. Another indication of preterm labor is a vaginal watery or bloody discharge in addition to the contraction. However, if you contact your doctor at an early stage, it is often possible to prevent premature delivery by means of medication, bed rest or similar.
During the physical examination to evaluate premature contractions, the vaginal palpation is performed. The length of the cervix, the width and consistency of the cervix and the palpable part of the baby are assessed. The length of the cervix is then measured with vaginal ultrasound (norm: 3.5-5cm) and it is assessed whether a so-called funnel has formed.
This indicates that the birth is imminent. A smear is taken to rule out infection, both for bacteria and for chlamydia and mycoplasma. Likewise the pH-value of the outflow is determined (norm: 4, with bubble burst: more basic = higher, approx.
around 8, thus the premature birth risk increases) and with a special test a bubble burst is excluded. During blood sampling, the inflammation parameters (leukocytes and CRP) are determined to exclude an amniotic infection. The urine is also examined. In addition, a cardiotocogram (CTG) is recorded with the child’s heart action and the contractions of the uterus. An ultrasound scan is performed to assess the health of the child.
