Braxton Hicks contractions

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Braxton Hicks contractions
Other namesPractice contractions, false labor
Specialty Obstetrics

Braxton Hicks contractions, also known as practice contractions or false labor, are sporadic uterine contractions that may start around six weeks into a pregnancy. [1] However, they are usually felt in the second or third trimester of pregnancy. [2]

Contents

Associated conditions

Braxton Hicks contractions are often confused for labor. Braxton Hicks contractions allow the pregnant woman's body to prepare for labor. [1] However, the presence of Braxton Hicks contractions does not mean a woman is in labor or even that labor is about to commence. [1] Another common cause of pain in pregnancy is round ligament pain.

Table 1. Braxton Hicks contractions vs. true labor [1]

Braxton Hicks ContractionsTrue Labor Contractions
Cervical Dilation Do not cause cervical dilationCause cervical dilation
Frequency of ContractionsThe timing between contractions is not regularThe timing between contractions is regular and the contractions begin to occur closer together over time
Strength of ContractionsThey are not usually very strongThey become stronger over time
Length of ContractionsLength is uncertainThe contractions last between 30–90 seconds and grow longer as labor progresses
Location of PainUsually the pain is in the front of the abdomenThe pain starts in the back and moves around to the front.
Change with MovementContractions may stop if the woman movesContractions will continue and/or become stronger regardless of the woman's movements

Pathophysiology

Although the exact causes of Braxton Hicks contractions are not fully understood, there are known triggers that cause Braxton Hicks contractions, such as when a pregnant woman: [1] [3]

There are two thoughts for why these intermittent uterine muscle contractions may be occurring. The first is that these early “practice contractions” could be helping to prepare the body for true labor by strengthening the uterine muscle. [1] The second is that these contractions may occur when the fetus is in a state of physiological stress, in order to help provide more oxygenated blood to the fetal circulation. [1]

Signs and symptoms

The determination of Braxton Hicks contractions is dependent on the history and physical assessment of the pregnant woman's abdomen, as there are no specific imaging tests for diagnosis. [1] The key is to differentiate Braxton Hicks contractions from true labor contractions (see Table 1 above).

Most commonly, Braxton Hicks contractions are weak and feel like mild cramping that occurs in a localized area in the front abdomen at an infrequent and irregular rhythm (usually every 10-20 minutes), with each contraction lasting up to 2 minutes. [1] [2] [3] They may be associated with certain triggers and can disappear and reappear; they do not get more frequent, longer, or stronger over the course of the contractions. [1] However, as the end of a pregnancy approaches, Braxton Hicks contractions tend to become more frequent and more intense. [1]

On a physical exam, some uterine muscle tightening may be palpable, but there should be no palpable contraction in the uterine fundus and no cervical changes or cervical dilation. [1] Braxton Hicks contractions do not lead to birth. [1]

More concerning symptoms that may require assessment by a healthcare professional include: [1]

Management

Although there is no specific medical treatment for Braxton Hicks contractions, some alleviating factors include: [1] [3]

History

Braxton Hicks contractions are named after John Braxton Hicks, the English physician who first wrote about them in Western medicine. [4] In 1872, he investigated the later stages of pregnancy and noted that many pregnant women felt contractions without being near birth. [4] He examined the prevalence of uterine contractions throughout pregnancy and determined that contractions that do not lead to labor are a normal part of pregnancy. [4]

Related Research Articles

<span class="mw-page-title-main">Childbirth</span> Expulsion of a fetus from the pregnant mothers uterus

Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million human births globally. In the developed countries, most deliveries occur in hospitals, while in the developing countries most are home births.

Uterine contractions are muscle contractions of the uterine smooth muscle that occur during the menstrual cycle and labour. Uterine contractions occur throughout the menstrual cycle in the non-pregnant state and throughout gestation.

A hysterotomy is an incision made in the uterus. This surgical incision is used in several medical procedures, including during termination of pregnancy in the second trimester and delivering the fetus during caesarean section. It is also used to gain access and perform surgery on a fetus during pregnancy to correct birth defects, and it is an option to achieve resuscitation if cardiac arrest occurs during pregnancy and it is necessary to remove the fetus from the uterus.

False pregnancy is the appearance of clinical or subclinical signs and symptoms associated with pregnancy although the individual is not physically carrying a fetus. The mistaken impression that one is pregnant includes signs and symptoms such as tender breasts with secretions, abdominal growth, delayed menstrual periods, and subjective feelings of a moving fetus. Examination, ultrasound, and pregnancy tests can be used to rule out false pregnancy.

Cervical dilation is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally, or may be induced surgically or medically.

Bloody show or show is the passage of a small amount of blood or blood-tinged mucus through the vagina near the end of pregnancy. It is caused by thinning and dilation of the cervix, leading to detachment of the cervical mucus plug that seals the cervix during pregnancy and tearing of small cervical blood vessels, and is one of the signs that labor may be imminent. The bloody show may be expelled from the vagina in pieces or altogether and often appears as a jelly-like piece of mucus stained with blood. Although the bloody show may be alarming at first, it is not a concern of patient health after 37 weeks gestation.

<span class="mw-page-title-main">Uterine rupture</span> Medical condition

Uterine rupture is when the muscular wall of the uterus tears during pregnancy or childbirth. Symptoms, while classically including increased pain, vaginal bleeding, or a change in contractions, are not always present. Disability or death of the mother or baby may result.

<span class="mw-page-title-main">Prelabor rupture of membranes</span> Medical condition

Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor. Women usually experience a painless gush or a steady leakage of fluid from the vagina. Complications in the baby may include premature birth, cord compression, and infection. Complications in the mother may include placental abruption and postpartum endometritis.

A contraction stress test (CST) is performed near the end of pregnancy to determine how well the fetus will cope with the contractions of childbirth. The aim is to induce contractions and monitor the fetus to check for heart rate abnormalities using a cardiotocograph. A CST is one type of antenatal fetal surveillance technique.

<span class="mw-page-title-main">Cervical effacement</span>

Cervical effacement or cervical ripening refers to the thinning and shortening of the cervix. This process occurs during labor to prepare the cervix for dilation to allow the fetus to pass through the vagina. While this a normal, physiological process that occurs at the later end of pregnancy, it can also be induced through medications and procedures.

Cervical weakness, also called cervical incompetence or cervical insufficiency, is a medical condition of pregnancy in which the cervix begins to dilate (widen) and efface (thin) before the pregnancy has reached term. Definitions of cervical weakness vary, but one that is frequently used is the inability of the uterine cervix to retain a pregnancy in the absence of the signs and symptoms of clinical contractions, or labor, or both in the second trimester. Cervical weakness may cause miscarriage or preterm birth during the second and third trimesters. It has been estimated that cervical insufficiency complicates about 1% of pregnancies, and that it is a cause in about 8% of women with second trimester recurrent miscarriages.

Prostaglandin E<sub>2</sub> Chemical compound

Prostaglandin E2 (PGE2), also known as dinoprostone, is a naturally occurring prostaglandin with oxytocic properties that is used as a medication. Dinoprostone is used in labor induction, bleeding after delivery, termination of pregnancy, and in newborn babies to keep the ductus arteriosus open. In babies it is used in those with congenital heart defects until surgery can be carried out. It is also used to manage gestational trophoblastic disease. It may be used within the vagina or by injection into a vein.

<span class="mw-page-title-main">Uterine atony</span> Loss of tone in the uterine musculature

Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation. Therefore, a lack of uterine muscle contraction can lead to an acute hemorrhage, as the vasculature is not being sufficiently compressed. Uterine atony is the most common cause of postpartum hemorrhage, which is an emergency and potential cause of fatality. Across the globe, postpartum hemorrhage is among the top five causes of maternal death. Recognition of the warning signs of uterine atony in the setting of extensive postpartum bleeding should initiate interventions aimed at regaining stable uterine contraction.

<span class="mw-page-title-main">Vaginal delivery</span> Delivery through the vagina

A vaginal delivery is the birth of offspring in mammals through the vagina. It is the most common method of childbirth worldwide. It is considered the preferred method of delivery, with lower morbidity and mortality than caesarean sections (C-sections).

An asynclitic birth or asynclitism are terms used in obstetrics to refer to childbirth in which there is malposition of the head of the fetus in the uterus, relative to the birth canal. Asynclitic presentation is different from a shoulder presentation, in which the shoulder is presenting first. Many babies enter the pelvis in an asynclitic presentation, and most asynclitism corrects spontaneously as part of the normal birthing process.

A uterotonic, also known as an oxytocic or ecbolic, is a type of medication used to induce contraction or greater tonicity of the uterus. Uterotonics are used both to induce labor and to reduce postpartum hemorrhage.

Uterine Tachysystole is a condition of excessively frequent uterine contractions during pregnancy. It is most often seen in induced or augmented labor, though it can also occur during spontaneous labor, and this may result in fetal hypoxia and acidosis. This may have serious effects on both the mother and the fetus including hemorrhaging and death. There are still major gaps in understanding treatment as well as clinical outcomes of this condition. Uterine tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a 30-minute period.

Signs and symptoms of pregnancy are common, benign conditions that result from the changes to the body that occur during pregnancy. Signs and symptoms of pregnancy typically change as pregnancy progresses, although several symptoms may be present throughout. Depending on severity, common symptoms in pregnancy can develop into complications. Pregnancy symptoms may be categorized based on trimester as well as region of the body affected.

<span class="mw-page-title-main">Prolonged labor</span> Medical condition

Prolonged labor is the inability of a woman to proceed with childbirth upon going into labor. Prolonged labor typically lasts over 20 hours for first time mothers, and over 14 hours for women that have already had children. Failure to progress can take place during two different phases; the latent phase and active phase of labor. The latent phase of labor can be emotionally tiring and cause fatigue, but it typically does not result in further problems. The active phase of labor, on the other hand, if prolonged, can result in long term complications.

<span class="mw-page-title-main">Emergency childbirth</span>

Emergency childbirth is the precipitous birth of an infant in an unexpected setting. In planned childbirth, mothers choose the location and obstetric team ahead of time. Options range from delivering at home, at a hospital, a medical facility or a birthing center. Sometimes, birth can occur on the way to these facilities, without a healthcare team. The rates of unplanned childbirth are low. If the birth is imminent, emergency measures may be needed. Emergency services can be contacted for help in some countries.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Raines, Deborah A.; Cooper, Danielle B. (2020). "Braxton Hicks Contractions". StatPearls. Treasure Island, FL: StatPearls Publishing. PMID   29262073 . Retrieved 2020-10-29.
  2. 1 2 Hennen, Leah; Linda Murray; Jim Scott (2005). The BabyCenter Essential Guide to Pregnancy and Birth: Expert Advice and Real-World Wisdom from THE tip Top Pregnancy and Parenting Resource. Emmaus, Penn.: Rodale Books. ISBN   1-59486-211-7.
  3. 1 2 3 "Braxton Hicks Contractions". 2017-11-10. Archived from the original on 2017-11-10. Retrieved 2021-09-13.
  4. 1 2 3 Dunn PM (1999). "John Braxton Hicks (1823–97) and painless uterine contractions". Arch. Dis. Child. Fetal Neonatal Ed. 81 (2): F157–58. doi:10.1136/fn.81.2.F157. PMC   1720982 . PMID   10448189.