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Preterm labor issues - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Pregnancy
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
Doctor :   hi
Doctor :   how can I help you?
User :   Hi Doctor........
Doctor :   Dr. XXXXXXXX here.
Doctor :   please proceed with your health query
User :   Dr. XXX..I talked to you before 2-3 times..
Doctor :   yes, I remember, please proceed.
User : I am 36 weeks pregnant...and I went into preterm labor at 32 weeks, at that time I went to the hospital with your suggestion only....after stopping preterm labor I came to home
User :   but my cervix was 4cm, 80%, -1 level(fetal head)
User :   after that also...sometimes I got pain in lower abdomen and having contractions
Doctor :   ok
User :   after that there is no change in cervix till last week
Doctor :   was cervical dystocia ruled out for you?
User :   doctor said..everything is normal
Doctor :   ok
User :   last week, I went to the doctor on Tuesday, and she said...I do have little protein in urine and other than that I do got lot of swelling over the body and due to that gained lot of weight
User :   so..she sent me for lab test for preclamsia...
Doctor :   ok, what did the work up show?
User :   Today I do have appointment and will know the results..mean this week...i got lots of differences in my body
User :   I don't know the results
Doctor :   could you describe the changes you are feeling in your body?
User :   on last Thursday...I woke from bed with right side lower abdomen pain at 4 am
Doctor :   ok
User :   and with contractions
User :   it last for 3-4 hours and pain is too much, after that it got reduced
Doctor :   ok
User :   and again...on Saturday, i had same kind of pain in the evening....
User :   and lasted for 3-4 hours
User :   and I do have the right lower abdomen and right lower back
User :   with regular contractions
Doctor :   have you had extra work on these two days?
User :   contractions with 4-5 mins apart
Doctor :   that could have precipitated such pain?
User :   no doctor...just taking rest at home...not even doing anything
Doctor :   ok
Doctor :   did your treating doctor prescribe anything to control the pain? or did he/she say to comeback when it gets worse?
User :   no
Doctor :   how was the baby's heart rate in your last check-up?
User :   baby heart is fine
User :   checking at home
User :   everyday
Doctor :   ok
Doctor :   continue to check atleast 3 times a day
User :   doctor told if i have pain for 1-2 hours then asked me to call
User :   but i am just seeing if ot goes or stays
Doctor :   are you walking daily? it helps baby's head to descend further down.
User :   little feets are swelled like anything
Doctor :   ok, yes if the contraction last for more than 45 seconds and come every 1-2 minutes, you should report to the birth center/hospital
User :   ok
Doctor :   the feet sweeling coul dbe due to the protien leak in urine and a feature of pre-eclamsia
User :   ok
Doctor :   make sure to lift your legs up when sitting or lying down. you can use pillows for the same
User :   ok
Doctor :   continue to monitor baby's heart rate about 2-3 times a day, while being on a contraction and immediately after that
User :   ok
Doctor :   to see the effects of the contraction on the baby
User :   again..I got pain 3 am and now it is 6 am....i got pain when I am in sleep and i couldn't able to lie down..and got up....
Doctor :   if you have any changes with the heart rate dipping below 120 beats per minute
Doctor :   report to your doctor immediately
User :   i am getting contraction with pain, for every 5 mins and lasting 45secs-1 min
Doctor :   do get the pains more often when you are resting? or do you get them when you are awake?
User :   I got in both situation
Doctor :   ok. when the frequency increases to 1-2 minutes gap between contraction athat last more than 30-45 seconds, then you should go for the birth center/hospital
Doctor :   it would indicate active labor
User :   but it starts in my lower right abdomen and lower right back...most pain
User :   but is this normal doctor?
Doctor :   until then wait and watch if possible until baby is 37 weeks old
User :   why I am getting pains like this doctor?
Doctor :   the pains that you are feeling is due to overreactive uterus that is contracting with the baby movements
Doctor :   which are a normal thing to happen in late pregnancy
User :   ok
Doctor :   it also happens in early pregnancy, but are very light to be observed
User :   ok
Doctor :   what you are getting is due to the first reason I gave
Doctor :   so since you are nearing 37 weeks in sometime, you doctor will be waiting and watching for you to go into active labor
Doctor :   and not suppress the uterus reaction
User :   ok
Doctor :   if these pains are felt before 32-33 weeks, then medications are given to make the uterus rest
User :   ok
Doctor :   and avoid the patient going into active labor which is then called as 'pre-mature labor pains'
User :   ok
Doctor :   and the baby is born pre-maturely needing ICU care
User :   yes doctor
Doctor :   so in your case, best will be to wait and watch, keep monitoring baby's heart rate
User :   that's y, they stopped my labor at 32 weeks and they have given steroids...
User :   yeas doctor...
Doctor :   and report to your doctor immediately if heart rate drops and you get pains more frequently
User :   but I am really worried in this pregnancy doctor...I am scare to see my test results today
User :   ok doctor
Doctor :   the steroids would have been given to speed up the lung development in baby specifically the 'surfactant'
User :   now also baby moving alot
Doctor :   so that even if baby is born before 37 weeks, he/she should not have any trouble
User :   ok, when ever i get contractions....between contraction to contraction..he moves
User :   and on last saturday....i got contractions....2-3 mins apart for more than 1 hour...
Doctor :   ok
User :   these contractions and pains..making me sick doctor...
Doctor :   wait till you get contractions every 1-2 minutes gap lasting more than 30-45 seconds
Doctor :   yes, i can understand, it is almost like active labour
User :   doctor..can this lead into active labor?
User :   why pain getting stop after sometime?
User :   and after bearing for 4 hours>
User :   does...I have any problem in my body?
Doctor :   it can happen, do not worry since the baby is fine
User :   and i am having...pressure in bowel as well
User :   feeling like gas, but no gas
Doctor :   that would be because baby's head being in pelvis and pressing on the rectum
User :   ok, appetite also good, eating and feeling hungry
User :   only my concern is pain
User :   even i am getting contractions without pain
Doctor :   wait for your test results today
Doctor :   and discuss with your doctor about what can be done
User :   doctor, will contractions hurt baby?
User :   frankly speaking..they don't even discuss 50% of you...what I ask, they say everything is fine..fine ...fine
User :   that's it
Doctor :   no contractions will not hurt the baby since baby is protected with amniotic fluid cushion
User :   that's why...i am connecting to you...last time..I am connected to some other doctor and not satisfied....if I connect in my night time only i get connected to you
Doctor :   I am available between 9AM -4:30PM IST.
User :   ok
User : small doubt...i am having contractions for long time and having pain sometimes...will this change my cervix this time? is there any chance?
Doctor :   with continued contractions, baby's head will be pushed more into pelvis, and this will make your cervix to open
Doctor :   you are already 80% effaced, so this should not take a very long time
Doctor :   you need to monitor your contractions and baby's heart rate
User :   this time also..if doctor says same...what should I ask her?
Doctor :   ask her if there is any cervical dystocia, and if they will give anything to ripen your cervix, such that it dilates easily with each contraction
Doctor :   also i would like to know, when was recent scan done for you?
User :   at 32 weeks doctor
Doctor :   what was the the baby's expected birth weight according to the scan report?
User :   when i got admitted in the hospital
User :   at that they said 5 lbs
User :   but not sure about expected birth weight
Doctor :   if the baby's weight is more, that is to say if it is a big baby, even then it will take time to come down and it will be difficult for head to engage
User :   because..they ar thinking that, I may go in labor anytime...
Doctor :   ok. in your last examination, did the doctor tell you if baby's head is engaged?
User :   I didn't ask...but they r saying like fetal head station levels
Doctor :   if teh baby is reached station '0', then you should be in hospital
Doctor :   you were at -1 last time, which means that baby's head is still not passed completely into pelvis
User :   from last 3-4 weeks baby head is in -1 level and in one ckeckup they said 0 level
Doctor :   so wait for your next examination today after your reports come.
User :   ok
User :   why I am getting more pain in right lower abdomen, doctor, (now also i am suffering with the pain)
Doctor :   it cold be due to head pressure more at that side
User :   ok
Doctor :   as compared to left side.
User :   ok
User :   why my water didn't break yet doctor? (lot of people says that..their water that)
Doctor :   it is not a must that your water should break.
Doctor :   some people have it intact till babys head is seen on the perineum
Doctor :   so it varies from woman to woman and from pregnancy to pregnancy
User :   ok
User :   sometimes..I am getting very hard contractions..will not contractions break water?
User :   in that time..i can't even take breath freely
Doctor :   not necessary that contractions will break the water, as I said, some people have it intact till babys head is seen on the perineum (that is the maximum strength of contraction)
User :   ok
Doctor :   would you like to take a second opinion on your condition from our panel gynecologist?
Doctor :   you can do so today after you get your work-up reports
Doctor :   make sure to take a copy of them
User :   but they don't give doctor
Doctor :   and send us on YYYY@YYYY
User :   they don't give any reports copy
Doctor :   oh ok.
Doctor :   then it will be difficult
User :   but i will ask details
Doctor :   you will need to remember what they say
User :   surely
User :   My case is became problem Doctor..getting good contractions and pains....but pain getting stopped by itself after sometime....don't know when goto hospital..don't know..when it is serious to take..don't know...what is going to happen...
Doctor :   WWW.WWWW.WW User :   ok
Doctor :   this is the link to take second opinion from our panel gynecologist
Doctor :   you can speak over phone to her
Doctor :   and ask her all your doubts
User :   ok
Doctor :   as i said earlier your decision to go to hospital will be based on two things
Doctor :   1) babys heart rate
Doctor :   2) timing of contractions
User :   ok
Doctor :   that is contractions every 1-2 minutes lasting 30-45 seconds or more
User :   ok
Doctor :   do not be confused over these two points
User :   contractions without pain?
Doctor :   get back to me if you are having doubts
User :   as you asked about baby head is engaged, what that mean doctor?
Doctor :   sometimes it can happen that you get contractions, but do not experience pain. count them as well
Doctor :   engagement means babys head getting into your pelvic caity
Doctor :   *cavity
User :   ok
User : of my friend also pregnant and she is now 39 weeks, in her recent scan they told that baby neck has cord
User :   can she will have normal delivery, still?
Doctor :   until labotr starts, or until 36 weeks, babys haed is floating, that is to say it is in abdomen side , not in pelvis
User :   ok
Doctor :   cord around teh neck if not causing harm to baby, normal delivery can be tried
Doctor :   but it has risks
User :   ok
Doctor :   so it is better to go in for cesarean
User :   ok
User :   -1 is not engaged yet?
Doctor :   have you followed what I said?
Doctor :   no, not completely engaged
User :   yes doctor...i feel better when I talked to you..
Doctor :   wait til it says '0' station in your examination
User :   ok
Doctor :   you can contact me anytime between 9Am-4:30 Pm IST
User :   my time is about to end....will talk to you later doctor..thanks for everything
Doctor :   i wil be there to help you.
Doctor :   sure
User :   wil update the results
Doctor :   take care.
User :   thanks doctor
Doctor :   thanks for consulting me. bye for now.
User :   sure..bye
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