Preterm labor

Defined as the presence of uterine contractions of sufficient frequency and intensity to effect progressive effacement and dilation of the cervix prior to term gestation between 20 and 37 weeks.

Precedes almost half of preterm births and such births occur in approximately 12% of pregnancies and is the leading cause of neonatal mortality in the United States.

2% of American women delivering very premature infants (< 32 wk).

Incidence is increasing globally.

Preterm delivery, defined as delivery before 37 weeks of gestation occurs in 15 million pregnancies each year and is the leading cause of early childhood complications and death.

Preterm delivery as defined as delivery before 34 weeks of gestation represent approximately 20% of all preterm deliveries and and account for the largest burden of neonatal deaths and childhood disability.

Neonatal mortality rates for newborns born in the United States are 5 per 1,000 babies.

Defined as the birth of a baby before the developing organs are mature enough to allow normal postnatal survival.

Premature infants are at greater risk for complications, including disabilities and impediments in growth and mental development.

Among the top causes of death in infants worldwide.

Cause of preterm labor is not known in 50% of preterm births.

There are 4 different pathways have been identified that can result in preterm birth: precocious fetal endocrine activation, uterine dissension, decidual bleeding, and intrauterine inflammation/infection.

One or more of the above pathways can occur over weeks or even months prior to preterm labor and birth.

Obstetric management of preterm includes:identification of risk factors associated with preterm birth, timely diagnosis, identifying the etiology, , evaluating fetal well-being, providing therapy to prolong gestation and reduce the incidence of respiratory distress syndrome, intra-amniotic infection, and initiating tocolytic therapy when indicated.

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