Are these sure signs of impending preterm labor? Nurses, doctors, midwifes, please respond!?

Question

Hi, I am asking this question for my brothers girlfriend who is 34wks3days pregnant with their first child. She has been experiencing contractions (cramping and extreme belly tightning) since about 10 last night. We took her to the hospital and they said she was contracting about every 5-8 minutes but after being there for about 3 hours there was no cervical change. (She was 1 cm dialated and 50% effaced when she checked in) So, they told us that the contractions weren't too worrisome because her cervix was not rapidly changing, However; now that we are back home the contractions are becoming a bit stronger and she is starting to feel very uncomfortable. She also has heavy discharge which is a new symptom today, and also the baby has not been moving as much at all! The nurse who checked her last night said the baby is in position and the head is very low. Her belly measures 35 and a half weeks. We would like to take her back to the hospital but...they told us only to return if the contractions get closer together or if her water breaks. She tried to nap but was even to uncomfortable for that. She is also very very uncomfortable with extreme "pitting edema", they said that her blood pressure was a little elevated but not to the point of total concern ( it was 167 over 78). We are a little worried and not sure what to do or when to panic...we don't want her to have to go back up to get sent home again with the same story as before.( we live over an hour from the hospital) Anyones info or personal experience or clinical experience is so greatly appreciated! We only want a happy healthy momma and baby boy (Ethan Lee). Thanks so much from the bottom of our hearts!

Answer 1

I am a former NICU nurse who had a high risk pregnancy that required bedrest from 8 weeks on and 90 days of hospital bedrest.

Let me say this, return to the hospital, demand to be admited to their antepartum floor. Get steriod shots for that babies lungs. Get them to administer terbuline or terb shots and magnesium sulfate to stop or delay labor. They did your sister in law and her baby a grave injustice by sending her home!

It sounds like she may be in preterm labor. At 34 weeks the lungs aren't done developing. Even if the baby measures 35 weeks, take in account ultrasound measurments are hardly ever correct. I had 10 3D ultrasounds to get gestational age determined. My son was born at "35" weeks but was later evaluated as born at 33 weeks and that 35 week estimation came from a maternal fetal doctor whom was rated #3 in the entire US! Having the steriod shots adminstered speeds up lung development.

Also, caucasian male babies satisticly do the worst in the NICU. We lovingly refer to them as 'wimpy white boys'. They just need a lot of extra help.

Delying labor would be the best bet. Terb and mag are the #1 choice. I am begging for you to go back because that unborn baby could have severe complications if born 6 weeks early. Not all babies do but! Some do. Its not worth the 'what if'.

Answer 2

It does sound like she could have some preeclampsia with the pitting edema and the elevated systolic pressure also preterm labor.  I would call the doctor.  He should check her urine for ketones.  I would think the goal would be for her to stay pregnant unless the preeclampsia/preterm labor gets too out of control.  This isn't braxton hicks.   I am suprised that the hospital did not give her magnesium to stop the contractions.  To be safe, I would be heading back to the hospital honestly.  If it is preterm labor and it advances too quickly it will be difficult for it to be stopped.  A baby born this early would most definately be spending time in the NICU, and likely have jaundice, feeding and breathing issues.  You are probably looking at a 4 lb baby.  The NICU stay would most likely be about 1 week.

My son was denied surfactant (to help develop the lungs at 32 weeks), he was born at 36 and went straight to the NICU for breathing issues.  I really think that he should have gotten it.

Answer 3

well i'm not a doctor or anything but i would call her doctor and tell them whats going on they may want you to start driving their since it does take an hour to get their. second if she is able to she should walk it helps labor progress even if you drive close to the hospital and walk around outside before you go in this may help and you have a beautiful baby soon. Good luck and god bless.