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Chapter-13 Preterm Labor

BOOK TITLE: Ward Rounds in Obstetrics and Gynecology

Author
1. Vijayalakshmi S
ISBN
9789352702398
DOI
10.5005/jp/books/18053_16
Edition
1/e
Publishing Year
2018
Pages
14
Author Affiliations
1. Adichunchanagiri Institute of Medical Sciences, Bellur, Karnataka, India
Chapter keywords
Preterm labor, cervical length, home uterine activity monitoring, fetal fibronectin, bacterial vaginosis, lower genital tract infection, fetal fibronectin test, progesterone therapy, tocolytics

Abstract

This chapter addresses the issue of preterm labor starting with the case history, examination, and investigations. Pertinent questions related to the issue are given in this chapter along with their crisp and to the point answers. It is important to educate patient to recognize the warning signs of preterm labor and approach for medical care at the earliest. Cerclage is reserved for women with history of cervical injury, uterine anomalies and/or progressive shortening of cervix despite progesterone therapy. Prophylactic cerclage is not indicated for all asymptomatic women with short cervical length. Patient with history of previous preterm birth, short cervix or both progesterone supplementation is recommended. Compared to multiple courses of steroid therapy single course of antenatal corticosteroids are proven to be beneficial in reducing the incidence of perinatal complication associated with premature babies born before 34 weeks of gestation. First line of tocolytic to be considered are calcium channel blockers based on due consideration of gestational age, etiology and contraindication to their use. Uses of antibiotics are of definite value in chorioamnionitis and GBS infection.

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