Threatened preterm labor

Threatened preterm labor refers to signs or symptoms suggesting that labor may begin before term. Below is general information about commonly reported symptoms, typical evaluation methods, risk factors and warning signs that require urgent assessment. This information does not replace professional medical evaluation; if you are concerned, contact a health care provider.

Common symptoms: what to watch for

Symptoms that may suggest threatened preterm labor include regular or increasingly frequent uterine contractions (cramp‑like or tightening sensations), vaginal bleeding or spotting, rupture or persistent leakage of amniotic fluid, a feeling of pelvic pressure, and a noticeable decrease in fetal movements. Any of these findings warrant clinical assessment. Heavy bleeding, severe abdominal pain, continuous fluid leakage or a marked reduction in fetal movement require prompt evaluation.

How it is evaluated

Evaluation usually begins with a detailed history and physical examination and may include fetal monitoring such as a non‑stress test (NST). Transvaginal ultrasound can measure cervical length; a sterile speculum or careful vaginal exam may be performed, along with urine and blood tests to check for infection or other concerns. The choice of tests depends on gestational age, symptom pattern and clinical findings.

Risk factors and prevention

Factors that can increase the risk of preterm birth include a prior preterm birth, multiple pregnancy (twins, etc.), previous cervical surgery, some infections, smoking and certain chronic medical conditions. Regular prenatal care, timely assessment of infections and open communication with your clinician help manage risk. Individual risk assessment is best done by your care team.

When to seek urgent care

Seek immediate care if you experience heavy or persistent abdominal pain, significant vaginal bleeding, sudden or continuous fluid leakage, regular contractions that grow stronger or closer together, or a clear reduction in fetal movements. These signs may require urgent assessment in an emergency department or by maternity services; providers may arrange rapid referral to Obstetrics/Perinatology or a labor and delivery unit as needed.

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