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Is it Preterm Labor?

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Women carrying twins are five to six times more likely to experience preterm labor, says Dr. John Elliott, a specialist in maternal-fetal medicine and partner with Phoenix Perinatal Associates, in Phoenix, Arizona. “And women are only able to self-diagnose about 15% of those contractions,” he says.

Experts think this may be because many of preterm labor’s signs, such as a backache and pelvic pressure, are what women carrying multiples expect to experience. “There’s also so much activity inside their womb, mothers might not recognize contractions,” says Dr. Elliott.

Knowing you’re at risk and not a good monitor of contractions means you should immediately discuss any concerns with your doctor. You may need to wear a belt with electronic sensors that detect contractions around your abdomen. Several times a day, the monitor is hooked to a telephone and relay graphs of uterine activity to a nurse.

Also, ask your doctor about tests to predict preterm labor, including frequent pelvic exams, checking cervical length by ultrasound, and measuring hormones in the saliva, and ways to postpone delivery, including medication. Listen to your body carefully and look for these early labor signs:

  • increased uterine contractions that are painful or painless (do not write them off as “Braxton Hicks” (false labor); let your doctor evaluate you)
  • menstrual-like cramps (these can come and go or be constant)
  • a low, dull backache
  • diarrhea
  • pelvic pressure (it feels like the babies are pushing down)
  • increased frequency of urination a change in color, amount, or consistency of vaginal discharge.
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