Response:

Preterm labor can occur even in pregnancies without risk factors like preeclampsia or gestational diabetes. Therefore, expectant mothers should vigilantly monitor for and promptly identify any unusual symptoms throughout their pregnancy.

During the third trimester, from 28 weeks onward, pregnant women commonly experience mild, irregular physiological contractions that resolve with rest, hydration, or a warm bath. Back pain or discomfort from the round ligaments, situated on either side of the uterus, are also normal pregnancy signs. As the fetus grows, a mother's center of gravity shifts, stretching these ligaments and causing sharp, immediate pain. This pain typically occurs with sudden movements, sneezing, or coughing, and tends to ease with rest or correct posture, unlike the cyclical nature of labor contractions.

Some pregnant women observe increased vaginal discharge, which typically retains its normal smell and color. This is attributed to estrogen and increased blood flow to the pelvic region, stimulating cervical glands to produce more discharge. This natural bodily mechanism helps cleanse the vagina and prevents bacteria from ascending into the uterus.

Beyond these normal physiological changes, certain other signs could indicate a potential risk of preterm labor and necessitate prompt recognition. For instance, the onset of frequent contractions that persist even after resting, drinking water, or changing positions is a significant warning. This indicates the uterus is actively contracting, potentially causing cervical dilation and expelling the fetus.

Expectant mothers should monitor symptoms by timing uterine contractions, specifically looking for the "5-1-1 rule". This rule indicates contractions occurring 5 minutes apart, each lasting one minute, and continuing for one hour, at which point immediate medical consultation is necessary.

Doctor Thao consults a pregnant woman at Tam Anh General Clinic, District 7. *Illustration: Ngoc Chau*

Dull, rhythmic lower back pain can be easily confused with benign discomfort. When the uterus begins to contract, nerves in the lower back become stimulated. This rhythmic pain, which comes and goes, often accompanies uterine contractions that may not be distinctly felt in the abdomen. If this pain persists despite changing positions, it could signal cervical dilation.

Changes in vaginal discharge, such as watery, bloody, or mucous discharge, or continuous leakage, signal a risk of preterm labor. As the cervix begins to open, the mucus plug—a protective barrier against bacteria entering the uterus—may detach, often with a small amount of red or brown blood. Persistent watery discharge or leakage could indicate premature rupture of membranes or amniotic fluid leakage, which heightens infection risk and can accelerate labor.

Should any unusual signs appear, immediate consultation with a doctor is advised for prompt management. During routine prenatal check-ups, proactively discuss even minor bodily changes with your doctor to ensure no abnormalities are overlooked. Depending on the specific case, the doctor will assess bleeding, abdominal pain, check for cervical changes, or use ultrasound to measure cervical length at appropriate gestational ages to evaluate preterm birth risk and guide closer monitoring.

Master of Science, Doctor Nguyen Phuong Thao

Fetal Medicine Specialist

Tam Anh General Clinic, District 7