Premonitory Signs & Symptoms Of Labor

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The series of changes happen in the uterus and cervix to facilitate onset of labor and accomplish childbirth. These premonitory signs and symptoms begin approximately 2-3 weeks prior to onset of labor in Primigravida but just few days prior in Multigravida.

Symptoms:

  • Lightening: Sensation of decreased abdominal distention and relief due to the descent of the fetal head into the pelvic inlet 2-3 weeks prior to onset of labor. 
  • Relief from breathlessness: As the fetal head descent, the pressure on the pulmonary diaphragm decreases, giving relief from breathlessness.
  • Increased Uterine contractions: Under the influence of hormonal changes and prostaglandins, the frequency, intensity and duration of false labor pain increases and they become more regular. Subsequently giving way to onset of true labor.
  • Discomfort and pain in lower abdomen, pelvis, lower back and inner thigh.
  • Difficulty in walking.
  • Increased frequency of urine.
  • Blood mixed mucus discharge from vagina.

Clinical Assessment:

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1- Abdominal Examination:

  • In Primigravida, the fetal head may be Fixed at pelvic brim and Engaged (Engaged = Maximum Biparital Diameter has entered Pelvic Brim) even before the onset of true labor.
  • In multipara, due to laxity of uterine muscles, the fetal head engage only with the onset of true labor and fetal descent.

2- Pelvic Examination:

  • Softening & Ripening of Cervix.

During later phase of pregnancy, the blood supply to cervix increases and the changes in its fibrous content leads to more water retention, resulting in softening and ripening of cervix.

  • Effacement & Dilation.

With the onset of true labor pains and descent of fetal head, the constant pressure on cervix leads to taking up of cervix into lower uterine segment and shortening of cervical length that is known as effacement. Further pressure and cervical pull leads to dilatation of internal and external os.

In primigravida, the cervical dilatation occurs after full effacement. However, in multipara, both occurs together with the onset of labor.

The patulous cervical os in multipara may be confused as cervical dilatation and hence, the other signs should be considered to establish onset of labor.

  • Show: Blood mixed mucus discharge from vagina notify the onset of labor.

Disclaimer:

The information is shared to create awareness towards Pregnancy and Childcare to reduce maternal and child deaths. Atmost care has been taken by the author to include the verified information from authentic sources. However, kindly discuss the same with your health care provider before implementation.