False Labor Pain Characteristics
The incorrect statement is B - false labor pain is NOT associated with the formation of a bag of waters (membrane rupture). Formation of the bag of waters (amniotic membrane bulging through the cervix) occurs during true labor when progressive cervical dilation and effacement are taking place, not during false labor 1.
Understanding False Labor vs. True Labor
The key distinction between false and true labor lies in whether progressive cervical dilation occurs. Contractile patterns have been studied extensively and have yielded little to facilitate differentiating real labor from false labor - the dilatation pattern alone is reliable for prospectively identifying true labor 1.
Characteristics of False Labor (Braxton Hicks Contractions):
More common in primigravidae than multigravidae - Statement A is CORRECT. First-time mothers more frequently experience and present with false labor concerns 1.
Contractions are irregular and unpredictable - Statement C is CORRECT. Unlike true labor, false labor contractions do not follow a consistent pattern of increasing frequency, intensity, or duration 1.
Pain is relieved by enema and sedation - Statement D is CORRECT. False labor pain typically responds to conservative measures including rest, hydration, position changes, enemas, and sedation, whereas true labor pain persists despite these interventions 1.
Why Statement B is Incorrect:
Formation of the bag of waters requires progressive cervical changes that occur only in true labor with active cervical dilation and effacement 1.
The amniotic membrane bulges through the dilating cervix as part of the normal labor progression, creating the visible "bag of waters" during active labor 1.
In false labor, the cervix remains unchanged - there is no progressive dilation or effacement, and therefore no mechanism for bag of waters formation 1.
Clinical Utility of Distinguishing False from True Labor:
Transvaginal ultrasound with cervical length cutoff of 1.5 cm has shown 81% specificity and 83% positive predictive value for distinguishing true from false labor in term nulliparous and multiparous patients, though this is not routinely used clinically 1.
Serial cervical examinations documenting progressive dilation remain the gold standard for confirming true labor 1.