Preterm labor: approach to decreasing complications of prematurity

Obstet Gynecol Clin North Am. 2015 Jun;42(2):255-74. doi: 10.1016/j.ogc.2015.01.004. Epub 2015 Mar 9.

Abstract

Obstetricians play a relevant role in minimizing neonatal morbidity and mortality for women in preterm labor. Tocolytic agents can delay preterm birth for at least 2 days, thus allowing the administration of antenatal corticosteroid and in-utero transfer to appropriate neonatal health care settings, interventions that reduce neonatal mortality and morbidity. Antibiotics besides group B streptococcus prophylaxis are not indicated. The benefit/risk ratio of amniocentesis has not been assessed yet. Magnesium sulfate significantly reduces the risk of cerebral palsy. Cesarean delivery benefits fetuses in breech presentation and those severely growth restricted at <34 weeks. In preterm infants delayed clamping is associated with significant benefits.

Keywords: Antibiotics; Corticosteroids; Delayed cord clamping; In utero transfer; Magnesium sulfate; Mode of delivery; Prematurity; Tocolysis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Cerebral Palsy / prevention & control*
  • Cesarean Section
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Magnesium Sulfate / administration & dosage*
  • Obstetric Labor, Premature / drug therapy
  • Obstetric Labor, Premature / prevention & control*
  • Pregnancy
  • Premature Birth / drug therapy
  • Premature Birth / prevention & control*
  • Prognosis
  • Tocolytic Agents / administration & dosage*

Substances

  • Adrenal Cortex Hormones
  • Tocolytic Agents
  • Magnesium Sulfate