Threatened premature labour

EBM Guidelines
Nov 8, 2018 • Latest change May 31, 2019
Ulla Ekblad

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Extract

  • The likelihood of premature labour becomes the greater the more of the following signs can be identified (signs 1–3 are the easiest to identify and, when seen together, often indicate the start of actual premature labour):
    1. regular, painful uterine contractions less than 10 minutes apart
    2. the contractions have lasted for more than an hour
    3. discharge of mixed blood and mucus
    4. bulging of foetal membranes is observed
    5. the cervix has disappeared
    6. the external os of the uterus is open to a finger.
  • Cervical ripening can be assessed by using the modified Bishop score; see Antenatal clinics: care and examinations1. Cervical-length measurement using ultrasound within specialized care is more reliable than clinical examination in predicting prematurity.
  • Irregular and weak uterine contractions are common during normal pregnancy.
  • If labour is not in progress, the condition of the cervix is followed up at the antenatal clinic every 1–3 weeks up to pregnancy week 34.
  • Inhibition of premature labour is usually not needed if the duration of pregnancy is at least 34 weeks (limit of full-term pregnancy is 37 weeks).

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