Braxton-Hicks Contractions in Pregnancy

Introduction

Braxton-Hicks contractions or false uterine contractions in a woman’s tenure of pregnancy is a term often less understood by many. It is not only a harmless phenomenon but also a common cause of anxiety in pregnant women who report this issue after the second trimester.

What Are False Contractions?

• Prodromal or false labor pains or sporadic contractions of the uterine muscles are referred to by gynecologists as Braxton-Hicks contractions.

• They can be certainly called false labor pains as they can be clearly distinguished from true pains depending on the intensity of contraction, the irregularity of the duration they last, and a source of an uncomfortable sensation in the uterus region rather than pain.

• True labor pains tend to be intense and painful in comparison, so as per case reports, false prodromal pains can be recognized by the patient’s description or complaint of the nature of discomfort experienced.

• These contractions are unpredictable and tend to occur more often in the third trimester, almost near the end of pregnancy. The main clinical differentiation by the patient should be that these pains in the third trimester (or less commonly in the second trimester) are almost of the same intensity, never varying to a higher degree of pain and duration.

• It will feel almost like the same uniform kind of discomfort that does not increase continuously or last for a long time.

How Can False Contractions Be Differentiated From True Labor Pains?

• A tightening sensation is described by most pregnant women that resemble menstrual cramping or abdominal tightness, or cramping. These contractions usually last less than 30 seconds and may be felt to a maximum of up to two minutes.

• True labor pains, on the other hand, last less than 90 seconds or 1.5 minutes and then become longer as the contractions progress. True labor contractions get stronger over time, whereas Braxton-Hicks contractions get weaker after the initial discomfort.

• True labor pains start approximately over the region of the mid-back and mid-abdominal areas. In contrast, false contractions are felt either in a specific abdominal area or only in the front portion of the abdomen.

• True labor pains will increase in intensity as the woman changes position, unlike the false Braxton-Hicks contractions that may even stop or become weaker in intensity eventually after a change in position.

What Is the Etiology of Braxton Hicks Contraction?

• More often, especially when a woman is in her first pregnancy, panic or anxiety might be caused to the pregnant woman thinking that true labor pains might have started prematurely in the second trimester or early in the third trimester.

• Some women become aware of these contractions as early as in the second trimester, and some mistakenly feel these false uterine contractions to be the labor pains in the third trimester nearing the end of pregnancy.

• In etiological fact, according to researchers, these contractions arise early, mainly due to less oxygenation or less blood flow to the placenta. The muscular fibers of the uterus tighten or contract considerably, giving a false idea of labor pain but are quite unrhythmic on observation.

• The trigger to these uterine contractions, though, is exactly not documented or elaborated in the medical literature; more often, the causes of stress to the fetus and increased blood flow to the placenta for improving fetal circulation the false contractions occur.

• These are thought of as the precursors or triggers of the early uterine contractions in the second or third trimester. Research indicates that Braxton-Hicks contractions play a role in preparing the uterine muscles for the act of birth, or it rather tones the uterine muscles to prepare for true labor pains that arise before the birth of the infant.

• They are assumed to have a role also in cervical softening but do not result in cervical dilation (cervical dilation occurs by true contractions or true labor pains, only at the end of the pregnancy period before culminating in childbirth).

• The fetal side of the placenta has chorionic plates to which the blood flow is increased in these contractions. The increased blood flow prompts better circulation, and oxygen-rich blood enters the fetal circulation.

What Is the Differential Diagnosis of Braxton Hicks Contractions and How Are They Managed?

• When the pregnant patient complains of the symptoms posed by the short-term nature or uneven unrhythmic intensity, the healthcare provider assures the patient that it is totally harmless and normal and is a physiologic phenomenon occurring to increase fetal circulation.

• However, if the patient reports any other clinical symptoms that are not associated with (normalized, but false) Braxton-Hicks contractions, like the leakage of fluid from the vagina, contractions that get stronger over a period, or the contractions that cause the woman difficulty in walking The healthcare provider should cross-check the condition.

• Vaginal bleeding is another major symptom that is not associated with these false contractions and may pose a clinical differential diagnosis to the healthcare provider (uterine fibroids, ascites, fluid retention, ovarian cysts, abdominal distention, hematometra, etc.).

• Apart from these abnormalities that can help the clinician distinguish the nature of these contractions (to identify that they are not false or true labor pains but rather a diagnostic condition that needs to be addressed at the earliest), other findings of the patient like burning on urination or pain and discomfort in the lower abdomen or even constipation that may sometimes cause excessive abdominal pain all need to be cross-checked and verified by the gynecologist or healthcare provider.

• These findings and other symptoms that have no link to either true or false contractions need immediate medical attention.

• Though the emergency department of the hospital function to ensure the patient’s awareness of the nature of these false pain or contractions, it is always beneficial for the healthcare provider to rule out urinary tract infections, appendicitis or cholecystitis, and other abnormal diagnostic findings or patient symptoms to double-check that the contractions arising prematurely are indeed just a Braxton-Hicks contraction.

Conclusion

While it is always wise and ideal to seek medical attention without further delay in pregnancy at any point in time. Patient awareness on differentiating true and false labor pains helps avoid emergency visits or unnecessary evaluation and prevents anxiety. While experiencing false contractions keep hydrated, move around and try changing positions. Practicing breathing can also help to control contractions.