PMID: 12763118May 24, 2003Paper

Problems and challenges in the management of preterm labour

BJOG : an International Journal of Obstetrics and Gynaecology
Helen M McNamara

Abstract

The main problem with preterm labour is our lack of progress in the successful management of this condition. We need to reassess our approach to this problem because preterm labour is not a disease, but an event, which may result from multiple independent pathways. This problem has also been affected significantly by medical advances such as infertility treatments and changes in neonatal survival at the limit of viability. The specific challenges that we face in managing preterm labour include: problems with definition; aetiology, including genetic and infection components; diagnostic problems, such as true versus false labour and role of cervical length and fetal fibronectin; and specific interventions according to the antepartum, intrapartum and postpartum challenges. In order to address the main issue, and make future progress in the management of preterm labour, we should consider the implementation of a 'Postpartum Preterm Labour Diagnostic Workup Protocol'. These data/workup results could be entered on web-based databases for each preterm labour 'event'. An international research team could analyse data relating to specific aetiological patterns and subgroup analyses, leading to the collaborative development of 'aetiology...Continue Reading

References

Dec 1, 1991·British Journal of Obstetrics and Gynaecology·J MacDougall, N Siddle
Jan 1, 1983·Journal of Perinatal Medicine·R F LamontM G Elder
Oct 1, 1995·British Journal of Obstetrics and Gynaecology·S Lavery, D Harvey
Mar 1, 1996·Birth·H F Sandmire
Apr 29, 1998·Current Opinion in Obstetrics & Gynecology·A D Bocking
Aug 8, 2001·Paediatric and Perinatal Epidemiology·S ArnonM Fejgin
Aug 25, 2001·Paediatric and Perinatal Epidemiology·R RomeroY M Kim
Aug 25, 2001·Paediatric and Perinatal Epidemiology·D S Dizon-Townson
Aug 25, 2001·Paediatric and Perinatal Epidemiology·M S KramerG Koren

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Citations

Apr 2, 2005·Obstetrics and Gynecology·Muriel DoretGeorge R Saade

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