Preterm labor : prediction and treatment

Cover......Page 1
Preface......Page 2
Uterine Contraction Assessment......Page 4
Normal uterine contractility......Page 5
Abnormal uterine contractility......Page 7
Potential interventions......Page 10
Clinical trials 1986 to 1989......Page 15
Clinical trials 1990 to 1993......Page 19
Clinical trials 1994 to 1997......Page 23
Meta-analysis of home uterine activity monitor......Page 25
Summary......Page 27
References......Page 28
Biochemical Markers for the Prediction of Preterm Labor......Page 31
Fetal fibronectin......Page 32
Estriol......Page 35
Corticotropin-releasing hormone......Page 37
beta-Human chorionic gonadotropin and alpha fetoprotein......Page 39
References......Page 40
Diagnosis of preterm labor and the limitations of manual cervical examination......Page 44
Technique of cervical sonography......Page 45
Evaluation of patients with suspected preterm labor......Page 47
When to measure transvaginal ultrasound cervical length in regards to contractions......Page 49
Management of preterm labor and cervical sonography......Page 50
Preterm labor, short cervical length, and infection......Page 51
The role of fetal fibronectin with cervical sonography in women with preterm labor......Page 52
What if the woman with preterm labor is bleeding?......Page 53
References......Page 55
Intrauterine infection and preterm birth......Page 58
Neonatal consequences of intrauterine infection......Page 59
Antibiotic treatment in patients with preterm labor......Page 60
Cervicitis......Page 63
Bacterial vaginosis......Page 64
Trichomoniasis......Page 65
Fetal fibronectin and intrauterine infection......Page 66
Distant infections and preterm birth......Page 67
References......Page 68
Why does preterm premature rupture of the membranes occur?......Page 72
What are the maternal risks associated with preterm premature rupture of the membranes?......Page 73
What are the fetal and neonatal risks of preterm premature rupture of the membranes?......Page 74
What evaluations should be considered for women with preterm premature rupture of the membranes?......Page 75
Where should conservative management be undertaken?......Page 76
How should the patient with preterm premature rupture of the membranes near term (32-36 weeks) be managed?......Page 77
How should the patient with premature rupture of the membranes remote from term (before 32 weeks\' gestation) be managed?......Page 78
Can the patient with preterm premature rupture of the membranes be managed as an outpatient?......Page 79
What are the considerations regarding group B streptococcus prophylaxis after premature rupture of the membranes?......Page 80
What is the optimal antibiotic regimen during conservative management of premature rupture of the membranes remote from term?......Page 81
How should the patient with preterm premature rupture of the membranes and cerclage be managed?......Page 83
Should antenatal corticosteroids be given in the setting of preterm premature rupture of the membranes?......Page 84
Are neurologic complications linked to preterm premature rupture of the membranes?......Page 85
References......Page 86
Preterm Labor in Twins and High-Order Multiples......Page 90
Interventions to lower background contractions......Page 95
References......Page 98
Does Cerclage Prevent Preterm Birth?......Page 101
Classification......Page 102
Elective cerclage......Page 103
Should low-risk patients be screened?......Page 104
Urgent cerclage......Page 105
Other than cerclage, are there any other adjunctive treatments with antibiotics, tocolytics, or steroids that may benefit the patient?......Page 109
Emergent cerclage......Page 110
What is the best way to reduce the membranes above the cervix before cerclage placement?......Page 111
Should antibiotics or tocolytics be used?......Page 112
Transabdominal cerclage......Page 113
References......Page 114
beta-Agonist Tocolytic Therapy......Page 117
Food and Drug Administration......Page 118
Physiology......Page 119
Efficacy......Page 120
Maternal effects......Page 122
Therapeutic plan......Page 124
Subcutaneous pump therapy......Page 125
Efficacy......Page 128
Costs......Page 136
Summary......Page 139
References......Page 140
Magnesium Sulfate: The First-Line Tocolytic......Page 145
Pharmacology, dosage, and maternal complications......Page 146
Fetal and neonatal effects......Page 148
General clinical efficacy......Page 149
Magnesium sulfate versus placebo......Page 150
Magnesium sulfate versus prostaglandin synthetase inhibitors......Page 151
Magnesium sulfate versus beta-mimetics......Page 152
Combination tocolytic therapy......Page 153
Clinical efficacy......Page 154
Special clinical situations......Page 156
Summary......Page 157
References......Page 158
Antiprostaglandin drugs: mechanism of action......Page 161
Cyclooxygenase specificity......Page 163
Pharmacokinetics of indomethacin......Page 164
Indomethacin efficacy as a tocolytic......Page 165
Fetal and neonatal complications associated with indomethacin......Page 167
Cyxlooxygenase-2 inhibitors: rationale and use in preterm labor......Page 171
Cyxlooxygenase-2 inhibitors: safety......Page 172
Cyxlooxygenase-2 inhibitors: efficacy as a tocolytic......Page 173
References......Page 174
Use of Calcium Channel Antagonists for Preterm Labor......Page 178
Effectiveness......Page 179
Contraindications......Page 180
Dosing and administration......Page 181
References......Page 182