Introduction to preterm labour (with mid trimester loss)
This tutorial costs £15.00
Preterm delivery, defined as delivery before 37 weeks of completed gestation (259 days), is a major cause of neonatal morbidity and mortality. Despite extensive research, preterm birth still accounts for 5–10% of all deliveries in developed countries and rates in Canada, the USA and France are on the increase. While mortality associated with preterm delivery has declined due to improvements in neonatal intensive care, preterm babies remain at risk of major complications including respiratory distress syndrome, necrotising enterocolitis, retinopathy of prematurity, sepsis, intraventricular haemorrhage, periventricular leucomalacia and long-term cognitive and sensory impairment. Preterm birth, therefore, carries significant cost implications to both healthcare services and society in general.
Preterm birth has a multi-factorial aetiology. Approximately 75% of deliveries occur as a result of spontaneous preterm labour, while the remainder follow intervention for maternal or fetal disorders that place the mother or fetus at risk, such as pre-eclampsia, fetal growth restriction, maternal diabetes and placenta previa or abruption.
Learning objectives The aims of this module are to review: - the factors associated with spontaneous preterm delivery
- methods employed in the prediction and prevention of preterm labour
- diagnosis of preterm labour
- management of preterm premature rupture of membranes (PPROM)
- management of spontaneous preterm delivery, including the use of tocolytics, steroids and antibiotics
- delivery of the preterm infant.
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Last updated: 27/08/09 (BJOG paper added in the 'Prediction of preterm labour' section)
01/04/09 (research paper added in the 'Preliminary reading' and 'The clinical problem' sections).