Published: 18 Jun 2025

ICD9: 644.00      ICD10: O60.00      ICD11: JB00

"Risk of preterm delivery, threatened preterm labor (TPTL)" refers to a situation where a pregnant woman is experiencing symptoms that suggest she may be going into labor before 37 weeks of gestation.
This is a serious concern because babies born prematurely can face a variety of health challenges. Let's break down each part:

Preterm Delivery: This means giving birth before 37 completed weeks of pregnancy. Normal gestation is around 40 weeks.
Threatened Preterm Labor (TPTL): This refers to the presence of symptoms that *suggest* labor might be starting early, but it doesn't necessarily mean that premature delivery is inevitable. It's a warning sign that requires medical attention.

Common Symptoms of Threatened Preterm Labor:

Regular or frequent contractions: These are uterine tightenings that occur at regular intervals.
Cramping: Menstrual-like cramps, especially in the lower abdomen.
Lower back pain: A dull ache or pressure in the lower back.
Pelvic pressure: A feeling that the baby is pushing down.
Vaginal discharge: A change in vaginal discharge, such as increased amount, watery discharge, or discharge that is blood-tinged (bloody show).
Rupture of membranes: This is when the amniotic sac (the "water bag") breaks.

What Happens If TPTL Is Suspected?

If a woman experiences symptoms of threatened preterm labor, she should contact her doctor or go to the hospital immediately. Medical professionals will typically:

Evaluate the symptoms: They'll ask about the frequency and intensity of contractions, the presence of other symptoms, and the woman's medical history.
Perform an examination: This may include a pelvic exam to check for cervical dilation (opening) and effacement (thinning).
Monitor the fetal heart rate: To ensure the baby is doing well.
Consider tests:
Fetal fibronectin (fFN) test: This test looks for a protein that can be a predictor of preterm labor. A negative test result often means that preterm labor is unlikely in the next 1-2 weeks.
Cervical length ultrasound: This measures the length of the cervix. A shorter cervix is associated with a higher risk of preterm birth.

Management of Threatened Preterm Labor:

The goal of management is to prevent or delay preterm delivery. This may involve:

Bed rest: This is often recommended, although its effectiveness is debated.
Hydration: Dehydration can sometimes trigger contractions.
Tocolytics: These are medications that can help to stop or slow down contractions. Common tocolytics include:
Magnesium sulfate
Nifedipine
Indomethacin
Corticosteroids: If preterm delivery is likely, corticosteroids (like betamethasone or dexamethasone) are given to the mother to help mature the baby's lungs. This significantly improves the baby's chances of survival and reduces the risk of complications if born prematurely.
Antibiotics: If there's a risk of infection (e.g., if the membranes have ruptured).

Important Considerations:

TPTL doesn't always lead to preterm birth. Many women who experience threatened preterm labor go on to deliver at term.
Prompt medical attention is crucial. Early diagnosis and management can improve outcomes for both the mother and the baby.
The specific management plan will depend on the individual circumstances including the gestational age of the pregnancy, the severity of the symptoms, and the woman's medical history.
Prevention is key. Factors that can increase the risk of preterm labor include:
Previous preterm birth
Multiple pregnancy (twins, triplets, etc.)
Certain medical conditions (e.g., high blood pressure, diabetes)
Infections
Smoking or drug use during pregnancy
Short intervals between pregnancies

In summary, "Risk of preterm delivery, threatened preterm labor (TPTL)" is a situation where a pregnant woman is experiencing symptoms that suggest she may be going into labor early. It requires prompt medical evaluation and management to try to prevent or delay preterm birth.