"irritable uterus"

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  During my first pregnancy five years ago I was taken out of work and put on total bed rest during my sixth month of pregnancy by my OBGYN.  The reason for this was I was expiriencing what was called by my doctor an irritable uterus.  During an exam he noticed the my uterus was contracting, it felt to me to be pressure and hardness of my uterus and I never gave it a second thought, becouse of what i was told about beracken hicks.  This feeling came and went every couple of hours and lasted 10-30 minutes sometimes it was uncomfortable but never painful.  He said it was not normal that often and we monitored them.  When they did not stop or lessen he put me out of work and put me on a muscle relaxer to help.  As he requested when i did feel my uterus contract for any lenth of time I went to the hospital where they monitored me gave me fluids interveiniously, and sent me home when they subsided.  I did dialate throughout the rest of my pregnancy a little at a time and I did efface the same. He took me off the medication 2 weeks before my due date and I gave birth 1 week late.
  During all of this I unfortunatly could not be on total bed rest, and although I was out of work I still was active and although I was put on medication the pressure of my uterus never subsided and I after a while I stopped calling him when it happened because I did not want to go to the hospital to go through the same thing of monitoring and fluids as it was frustrating when I left as my uterus would do the same thing.  
  It is five years later and I am 12 weeks pregnant with my second child and I am expireincing the tightness again in my uterus.  The same thing, comes and goes, uncomfortable, but not painful.  I do not feel the IVs, medication, and bed rest (or lack thereof), prolonged my pregnancy last time, as when he took me off the meds, I didnt have my son until three weeks later.  Can you please tell what to do differently this time, are there differnt medications I can take, and should I be concerned?  I feel as though I need a second opinion on what happened last time so I can better prepare this time around.  
  Thank you,
  
  Dannette J. Daniels
Dear Dannette J. Daniels:
Iritable uterus indicates that contractions are being note by the mother and/or the obstetrical provider. It can indicate "Braxton Hicks contractions" which are often characterized as the uterine muscle practising for labor or it can indicate true contractions that left alone will lead to delivery.
The key to differentiating these two states is change in the cervix: if there is effecement and worse is dilation, then these are true contractions and prevention (bed rest plus medications) of premature birth is very indicated. The problem is that you cannot know, with any run of contractions, which ones will stop and which ones will progress with cervical change. Thus, we ask patients to come for examination with each episode.
There are several medications that may dampen uterine irritability and thereby reassure both patient and physician.
Keywords: irritable uterus; preterm labor
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please contact your physician.