Some swelling of the legs and feet is normal. Excessive swelling in the hands and face are not, and you should call me immediately if you experience this. In addition, if you experience unusual headaches, you should call the office.
Sharp abdominal pain with bleeding or bright red bleeding is not normal and you must call the office immediately.

You may sense that your baby’s movements have subdued somewhat, however, what is happening is that as the baby grows, there is less room for him or her to move. Be aware of the overall patterns of movements as you progress. Please call the office if you have concerns about these patterns.

A gush of fluid from the vagina or continuous leaking should be evaluated. If you experience either, please call the office.

The onset of labor – If you experience contractions that are regular and are no more than 5 minutes apart, please call the office.

It’s always a good idea to have a suitcase packed and ready to take to the hospital … just in case. Here’s a handy checklist to help you.
http://my.webmd.com/content/article/49/39976.htm

Premature labor, also called preterm labor, is labor that starts before 36 weeks of pregnancy, or more than 3 weeks before your due date. Premature labor can often be stopped if you identify it early. Premature labor is related to 70% of infant deaths due to low birthweight. A low birthweight is 5 lbs, 8oz or less.

Warning Signs

• Uterine Contractions — If you feel like your uterus tightening or the baby balling up for four times or more in one hour.
• Menstrual-like Cramps — Cramps like those you may have during your period may come and go, or be constant.
• Abdominal Cramps — These feel like stomach cramps with or without diarrhea.
• Low Backache — This is a backache near your tailbone that comes and goes or is there constantly.
• Pelvic Pressure — This feels like the baby is pushing down in your vagina.
• Change in Vaginal Discharge — There may be a sudden change in your discharge. It may increase, or become more mucousy, watery or slightly bloody.

Experts do not really know the actual causes of premature labor, but some things that may put women at risk include:

• previous premature labor or delivery of a premature baby
• twin or triplet pregnancy
• medical problems, such as high blood pressure, diabetes, kidney or lung disease
• abnormality of the uterus or cervix
• abnormality of the placenta
• women under 17 years
• DES exposure

What to Do
If you have one or more of these warning signs, you could be in premature labor.

You should:

• Lie down
• Drink 2-3 glasses of water
• If the symptoms are not gone in 1 hour, call your doctor immediately.
• Call your doctor if you have any vaginal bleeding that is more than a light day of menstrual period or if you experience a sudden gush of fluid from your vagina.

When you finally do go into labor, you may feel generalized pain from time to time. This is normal. If you are uncomfortable at times, you may do any of the following:

• Sit in a warm bath
• Have someone give you a lower back massage. Using common household items such as a tennis ball or a rolling pin can be effective.
• Use ice, a heating pad, or a combination of both on your lower back.
• Consume water, juice or even a popsicle as a way of maintaining fluids.
• Generally speaking, anything you find relaxing is acceptable.
• By the time you go into labor, you will likely feel frequent contractions (sometimes referred to as Braxton-Hicks contractions). These are normal and are an indication that your body is preparing for actual labor. While the onset of labor is different for each woman, one of more of the following may occur as you begin to go into labor:

You may begin to suffer persistent back pain. Many times the pain will be accompanied by a feeling similar to premenstrual cramps.

The appearance of a mucous discharge. It might be slightly blood-tinged. This plug blocks the cervix and its passing indicates that labor could be imminent. Even if it’s several days away, this indicates that things are moving in the right direction.

You also may begin to suffer from diarrhea.

When you finally do go into labor, you may feel generalized pain from time to time. This is normal. If you are uncomfortable at times, you may do any of the following:

• Sit in a warm bath
• Have someone give you a lower back massage. Using common household items such as a tennis ball or a rolling pin can be effective.
• Use ice, a heating pad, or a combination of both on your lower back.
• Consume water, juice or even a popsicle as a way of maintaining fluids.
• Generally speaking, anything you find relaxing is acceptable.
• By the time you go into labor, you will likely feel frequent contractions (sometimes referred to as Braxton-Hicks contractions). These are normal and are an indication that your body is preparing for actual labor. While the onset of labor is different for each woman, one of more of the following may occur as you begin to go into labor:

You may begin to suffer persistent back pain. Many times the pain will be accompanied by a feeling similar to premenstrual cramps.

The appearance of a mucous discharge. It might be slightly blood-tinged. This plug blocks the cervix and its passing indicates that labor could be imminent. Even if it’s several days away, this indicates that things are moving in the right direction.

You also may begin to suffer from diarrhea.