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Journal of the Chinese Medical... May 2020
Topics: Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Obstetric Labor, Premature; Pregnancy; Risk Factors
PubMed: 32168077
DOI: 10.1097/JCMA.0000000000000296 -
Deutsches Arzteblatt International Mar 2013The percentage of preterm births in Germany is high at 9%, but stable. 77% of cases of perinatal death are in prematurely born infants. Intensive research efforts are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The percentage of preterm births in Germany is high at 9%, but stable. 77% of cases of perinatal death are in prematurely born infants. Intensive research efforts are being directed toward the development of new means of primary and secondary prevention, diagnostic assessment, and pharmacotherapy of premature labor.
METHODS
We review pertinent publications that were retrieved by a selective search of the literature from 1966 to 2012, including current meta-analyses from the Cochrane database and the guidelines of German and foreign obstetric societies.
RESULTS
Preterm labor is a multifactorial problem. The current treatment options are symptomatic, rather than causally directed. Preventive treatment with progesterone can lower the rate of preterm birth in high-risk groups by more than 30%. Transporting the pregnant women to an appropriately qualified perinatal care center and induction of fetal lung maturation lowers perinatal mortality. A variety of tocolytic drugs with different mechanisms of action (betamimetics, oxytocin antagonists, calcium-channel blockers, NO donors, and inhibitors of prostaglandin synthesis) can be used for individualized tocolytic treatment. Premature rupture of the membranes is an indication for antibiotics.
CONCLUSION
The goal of all attempts to prevent and treat preterm labor is to improve preterm infants' chances of surviving with as few complications as possible. The methods discussed here can be used to prolong pregnancies at risk for preterm labor and so to reduce perinatal morbidity and mortality.
Topics: Comorbidity; Female; Humans; Infant Mortality; Infant, Newborn; Maternal Age; Obstetric Labor, Premature; Pregnancy; Prevalence; Risk Assessment; Smoking; Social Class; Survival Analysis; Survival Rate
PubMed: 23596503
DOI: 10.3238/arztebl.2013.0227 -
Clinics in Perinatology Jun 1995The role of infection in the pathogenesis of preterm labor and delivery, and the specific mechanisms through which this association is demonstrated are presented.... (Review)
Review
The role of infection in the pathogenesis of preterm labor and delivery, and the specific mechanisms through which this association is demonstrated are presented. Cellular and biochemical changes that initiate parturition in the setting of infection are discussed, particularly prostaglandins and cytokines.
Topics: Animals; Bacterial Infections; Chorioamnionitis; Cytokines; Female; Humans; Infant, Newborn; Labor, Obstetric; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Prostaglandins; Uterine Diseases
PubMed: 7671540
DOI: No ID Found -
The Journal of the American Board of... 1992This paper, the first of a two-part series on premature labor, reviews the recent literature on the causes of and risk factors for preterm labor and methods of diagnosis. (Review)
Review
BACKGROUND
This paper, the first of a two-part series on premature labor, reviews the recent literature on the causes of and risk factors for preterm labor and methods of diagnosis.
METHODS
A review of the literature on risk determination and diagnosis of preterm labor was conducted by searching MEDLINE files from 1983 to the present, using the key terms "preterm labor," "premature labor," "preterm labor and infection," and "uterine monitoring." Additional references were accessed by cross-referencing the bibliographies of the articles obtained through this search.
RESULTS AND CONCLUSIONS
Risk factors for preterm labor, which include items related to the pregnant woman's demographic characteristics, history, daily habits, and current pregnancy, have been combined into scoring systems commonly used by clinicians and researchers to single out women at risk for preterm delivery. When such systems are tested in obstetric populations, results show variable success in predicting preterm labor or birth. These inconsistent results could be due, in part, to important factors that have often been omitted from scoring systems, such as chemical abuse, poor nutrition, little social support, demanding work, multiple sexual partners, past or current sexually transmitted diseases, and other gynecologic infections. Women who are considered high risk for preterm labor can benefit from participating in preterm birth prevention programs that incorporate home monitoring, patient education regarding the signs and symptoms of preterm labor, frequent contacts with health professionals, and cervical examinations.
Topics: Biomarkers; Evaluation Studies as Topic; Female; Fetal Monitoring; Genital Diseases, Female; Home Care Services; Humans; Infections; Maternal Health Services; Obstetric Labor, Premature; Pregnancy; Risk Factors; Severity of Illness Index
PubMed: 1414451
DOI: No ID Found -
The Journal of the American Board of... 1992As the second paper in a two-part series on preterm labor, this article discusses the management of preterm labor as it relates to risk reduction, tocolytic therapy,... (Review)
Review
BACKGROUND
As the second paper in a two-part series on preterm labor, this article discusses the management of preterm labor as it relates to risk reduction, tocolytic therapy, corticosteroids, and antibiotics.
METHODS
Published literature on the management of preterm labor was reviewed by searching MEDLINE files from 1983 to the present, using the terms "preterm labor," "premature labor," "preterm labor and antibiotics," "tocolytic agents," "tocolysis," "betamethasone," and "premature rupture of membranes." Additional references were obtained by cross-referencing bibliographies from available articles.
RESULTS AND CONCLUSIONS
Effective management of preterm labor and birth begins with an assessment and reduction of risks for all pregnant women. In addition, pregnant women should be screened and appropriately treated for urologic and gynecologic infections (e.g., syphilis, gonorrhea, Chlamydia, and bacterial vaginosis). Women who are at high risk for preterm birth should be enrolled in a preterm birth prevention program that includes frequent contact with health professionals, patient education about the signs and symptoms of preterm labor, home monitoring, and regular cervical examinations. For women who develop preterm labor that does not require immediate delivery, recommended management strategies include reduced activity, early tocolytic therapy, corticosteroids for up to 34 weeks' gestation (both for women with intact and ruptured membranes), and antibiotics for known infections. Early studies also suggest that prophylactic antibiotics can be beneficial for women with idiopathic preterm labor or preterm premature rupture of membranes.
Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Clinical Protocols; Female; Fetal Membranes, Premature Rupture; Humans; Obstetric Labor, Premature; Pregnancy; Risk Factors; Tocolysis
PubMed: 1462794
DOI: No ID Found -
Duodecim; Laaketieteellinen... 1998
Review
Topics: Female; Finland; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Very Low Birth Weight; Maternal Health Services; Neonatology; Obstetric Labor, Premature; Pregnancy; Risk Factors
PubMed: 11757115
DOI: No ID Found -
The Journal of Reproductive Medicine Jan 1988A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from... (Review)
Review
A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls. Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity. Silent chorioamnionitis has been noted in 15% of patients in premature labor. Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear. Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria.
Topics: Anti-Bacterial Agents; Bacteria; Bacteriuria; Chorioamnionitis; Female; Humans; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Prostaglandins; Pyelonephritis
PubMed: 3278113
DOI: No ID Found -
The Journal of the American Board of... 1993
Topics: Adolescent; Adult; Family Planning Services; Female; Humans; Obstetric Labor, Premature; Pregnancy; Risk Factors; United States
PubMed: 8452073
DOI: No ID Found -
The Journal of the Medical Society of... Sep 1946
Topics: Female; Humans; Obstetric Labor, Premature; Pregnancy
PubMed: 21001677
DOI: No ID Found -
Birth Defects Original Article Series 1981
Topics: Arachidonic Acid; Arachidonic Acids; Calcium; Ethanol; Female; Glucocorticoids; Humans; Labor Onset; Obstetric Labor, Premature; Pregnancy; Progesterone
PubMed: 6793110
DOI: No ID Found