Braxton Hicks contractions

From WikiProjectMed
Jump to navigation Jump to search
Braxton Hicks contractions
Other names: Practice contractions, false labor, prodromal labor[1]
SpecialtyObstetrics
SymptomsCrampy abdominal discomfort or pain[2][3]
Usual onset>20 wks of pregnancy[4]
DurationAbout 30 sec[5]
CausesUnknown[1]
Diagnostic methodBased on symptoms, confirmed by vaginal exam[3]
Differential diagnosisLabor, round ligament pain, placental abruption, preeclampsia[5][1]
FrequencyCommon[1]

Braxton Hicks contractions, also known as false labor, are sporadic uterine contractions during pregnancy.[1] While they may begin in early pregnancy, they are not generally felt until after 20 weeks of gestation.[4][1] They are a normal part of pregnancy and generally become more common near delivery.[1]

While uncomfortable, the pain is typically only felt in the front of the abdomen.[2][3] They may occur a few times per day and last for about 30 seconds.[5] Unlike labor, they do not become stronger, more frequent, or last longer with time.[5] They may also resolve with drinking fluids or rest.[3]

The cause is unclear.[1] They may be triggered by activity, a full bladder, or dehydration.[1] Diagnosis may be supported by finding only part of the uterus contracting with no cervical dilation on vaginal exam.[1][3] They are named after John Braxton Hicks, the English physician who first described them in Western medicine.[6]

Signs and symptoms

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][7][8] 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]

  • Any bleeding or fluid leakage from the vagina
  • Contractions that are strong, frequent (every 5 minutes), and persisting for an hour
  • Changes or significant decreases in fetal movement

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][8]

  • is dehydrated
  • has a full bladder
  • has just had sexual intercourse
  • has been exercising (running, lifting heavy objects)
  • is under excessive stress
  • has had her stomach touched

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]

Diagnosis

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]

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.

Braxton Hicks[1] True labor[1]
Cervical dilation None Causes
Frequency of contractions Irregular Regular and becomes closer together over time
Strength of contractions Not usually very strong Become stronger over time
Length of contractions Length is uncertain Last between 30–90 seconds and becomes longer
Location of pain In front of the abdomen Often starts in the back and moves around to the front
Change with movement May stop if the woman moves Continue and becomes stronger

Management

Although there is no specific medical treatment for Braxton Hicks contractions, some alleviating factors include:[1][8]

  • Adequate hydration
  • Drinking warm milk, herbal tea, or having a small meal
  • Urination to empty a full bladder
  • Rhythmic breathing
  • Lying down on the left side
  • A mild change in movement or activity level
  • Relaxing and de-stressing (e.g., a massage, nap, or warm bath)
  • Trying other pain management techniques (e.g., practices from childbirth preparation class)

History

Braxton Hicks contractions are named after John Braxton Hicks, the English physician who first wrote about them in Western medicine.[6] In 1872, he investigated the later stages of pregnancy and noted that many pregnant women felt contractions without being near birth.[6] 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.[6]

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 Raines, Deborah A.; Cooper, Danielle B. (2020). "Braxton Hicks Contractions". StatPearls. Treasure Island, FL: StatPearls Publishing. PMID 29262073. Archived from the original on 2022-04-04. Retrieved 2020-10-29.
  2. 2.0 2.1 "Signs that labour has begun". nhs.uk. 1 December 2020. Archived from the original on 23 December 2023. Retrieved 16 January 2024.
  3. 3.0 3.1 3.2 3.3 3.4 "How to Tell When Labor Begins". www.acog.org. Archived from the original on 16 November 2023. Retrieved 16 January 2024.
  4. 4.0 4.1 Services, Department of Health & Human. "Pregnancy - premature labour". www.betterhealth.vic.gov.au. Archived from the original on 4 November 2023. Retrieved 16 January 2024.
  5. 5.0 5.1 5.2 5.3 "Contractions". NHS inform. Archived from the original on 4 October 2023. Retrieved 16 January 2024.
  6. 6.0 6.1 6.2 6.3 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.
  7. 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. Archived from the original on 2024-01-16. Retrieved 2023-11-21.
  8. 8.0 8.1 8.2 "Braxton Hicks Contractions". 2017-11-10. Archived from the original on 2017-11-10. Retrieved 2021-09-13.

External links

Classification