44. Management of Preterm Labor

  1. John T. Queenan MD2,
  2. Catherine Y. Spong MD3 and
  3. Charles J. Lockwood MD4
  1. Vincenzo Berghella MD

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch44

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Berghella, V. (2012) Management of Preterm Labor, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch44

Editor Information

  1. 2

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 3

    Bethesda, MD, USA

  3. 4

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • management of preterm labor;
  • pathophysiology, leading to PTB;
  • RPR or VDRL, in ruling out syphilis;
  • risk factors for preterm birth;
  • fetal fibronectin and cervical length;
  • preterm labor management algorithm;
  • principles of tocolytic therapy;
  • contraindications to tocolytic therapy

Summary

Major advances in reducing the incidence of prematurity will only come from a better understanding of the pathophysiology leading to preterm birth. Prevention efforts in asymptomatic women are more beneficial than treatment of symptomatic women. Despite massive research efforts in primary or secondary prevention, millions of women in the USA present with symptoms of preterm labor every year, and over 500,000 deliver before 37 weeks. Given the dire consequences of preterm birth, especially very early preterm birth (<32 weeks), everything should be done to avoid it even when it is most difficult (i.e. the woman has manifest symptoms of preterm labor). Management of the woman with symptoms of preterm labor starts with initial assessment of history, physical exam, and specific laboratory and other screening tests to establish diagnosis and prognosis, in order to obtain an accurate initial assessment and to determine the correct interventions.