Management of preterm birth best practices in prediction, prevention, and treatment
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| Format: | Buch |
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| Sprache: | English |
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Philadelphia, PA
Saunders
2012
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| Schriftenreihe: | Obstetrics and gynecology clinics of North America
39,1 |
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| 245 | 1 | 0 | |a Management of preterm birth |b best practices in prediction, prevention, and treatment |c guest ed. Alice Reeves Goepfert |
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| adam_text | Titel: Management of preterm birth
Autor: Goepfert, Alice Reeves
Jahr: 2012
Management of Preterm Birth: Best Practices in Prediction, Prevention, and Treatment
Contents
Foreword: Management Strategies to Prevent Preterm Birth xi
William F. Rayburn
Preface xiii
Alice Reeves Goepfert
Progesterone for Preterm Birth Prevention 1
Caria E. Ransom and Amy P. Murtha
Preterm birth—delivery before 37 weeks of gestation—is the second
leading cause of infant mortality in the United States after congenital
malformations. Spontaneous preterm birth, due to either preterm labor
or preterm premature membrane rupture, encompasses approximately
75% of all preterm births, almost 400,000 births per year. Since the
1960s, different formulations of progesterone have been investigated
for preterm birth prevention. This article addresses the use of proges-
terone for the prevention of preterm birth, including selection of
candidates for progesterone, pharmacokinetics, dosing, and formula-
tions. This article aims to provide a practical guide for using proges-
terone in clinical practice.
Periodontal Disease and Preterm Birth 17
Amanda L. Horton and Kim A. Boggess
Preterm birth (delivery at fewer than 37 weeks gestation) is the most
common cause of infant morbidity and mortality among nonanomalous
infants in the United States. Increasing evidence has focused on
associations between clinical infection, inflammation, and preterm
birth. Maternal periodontal disease, which is associated with systemic
inflammation, has been associated with preterm birth. Intervention trails
for treatment of periodontal disease during pregnancy, however have
not consistently shown a reduction in preterm birth rates. Despite the
lack of reduction in preterm birth, oral health maintenance is an
important part of preventive care and should be supported during
pregnancy.
Cervical Cerclage for the Prevention of Preterm Birth 25
John Owen and Melissa Mancuso
Evidence supports the concept that cervical insufficiency is but 1
component of the larger and more complex preterm birth syndrome.
Premature cervical ripening provides strong evidence that parturition
has begun and is the result of multiple interrelated pathways and
Contents
inciting factors. Ultrasonographic screening of the cervix and treatment
with cerclage for cervical shortening in the midtrimester is reserved for
women with prior spontaneous preterm birth. Although cerclage benefit
for short cervix 25 mm is inversely proportional to the length, it is
appropriate to offer cerclage to women with cervical length 25 mm,
and particularly those with a coexistent U-shaped funnel.
Late Preterm Birth: Management Dilemmas 35
Cynthia Gyamfi-Bannerman
The focus of this article is a description of the epidemiology and
management of late preterm pregnancy. Late preterm birth results from
spontaneous, indicated, and sometimes elective indications. The bur-
den of prematurity can be decreased if elective late preterm delivery is
eliminated. Certain conditions absolutely warrant late preterm delivery;
however, the clinician should weigh the risks of iatrogenic prematurity
with the benefits of delivery for maternal or fetal indication when
considering intervention for this cohort.
Antenatal Corticosteroids in the Management of Preterm Birth: Are We Back
Where We Started? 47
Clarissa Bonanno and Ronald J. Wapner
Even with recently declining rates, preterm birth remains a critical
public health problem. Administration of antenatal corticosteroids to
improve outcomes after preterm birth is one of the most important
interventions in obstetrics. This article summarizes the evidence for
antenatal corticosteroid efficacy and safety. Although antenatal corti-
costeroids are effective for singleton pregnancies at risk for preterm
birth between 26 and 34 weeks gestation, questions remain regarding
the utility in specific cases such as multiple gestations, very early
preterm gestations, and pregnancies complicated by intrauterine
growth restriction. Uncertainty also remains about length of corticoste-
roid effectiveness and need for repeat or rescue courses.
Antibiotics in the Management of PROM and Preterm Labor 65
Brian Mercer
A significant fraction of preterm birth results from subclinical intrauter-
ine infection. Antimicrobial treatment during conservative management
of preterm labor and premature rupture of the membranes (PROM)
remote from term could treat subclinical decidual colonization. There
are data supporting adjunctive antibiotic treatment during conservative
management of PROM remote from term, including broad-spectrum
agents. There is no consistent evidence that antibiotic treatment in the
setting of preterm labor with intact membranes prolongs pregnancy or
improves newborn outcomes; there is some evidence of risk. Antibiotic
treatment for pregnancy prolongation should not be offered in the
setting of preterm labor with intact membranes.
Contents ix
Tocolytic Therapy for Acute Preterm Labor 77
Adi Abramovici, Jessica Cantu, and Sheri M. Jenkins
Preterm birth is the leading cause of perinatal morbidity and mortality
and leads to significant health care costs annually. The decision as to
which tocolytic should be utilized as the first-line agent for a patient is
based on multiple factors, including gestational age, the patient s
medical history, common and severe side effects, and a patient s
response to therapy. This summary describes the most commonly used
tocolytics, their mechanisms of action, side effects, and clinical data
regarding their efficacy.
Early Term Births: Considerations in Management 89
Luisa Wetta and Alan T.N. Tita
The frequency of early term births varies by patient, provider, and
system characteristics. Early term deliveries in the absence of maternal
or fetal indications are associated with suboptimal neonatal outcomes
without evidence of maternal benefit. Demonstrated fetal lung maturity
before early term birth reduced the risk of respiratory and other
morbidities, but not to low levels seen at 39-40 weeks. Sometimes the
risk benefit ratio of early deliveries is unclear- provider and patient s
desires should direct care. Interventions that include administrative
support, review of indications, and feedback to providers can dramat-
ically reduce the frequency of early term births over time.
Index 99
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| indexdate | 2025-02-03T17:28:01Z |
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| isbn | 9781455739004 |
| language | English |
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| physical | XV, 105 S. Ill., graph. Darst. |
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| series | Obstetrics and gynecology clinics of North America |
| series2 | Obstetrics and gynecology clinics of North America |
| spellingShingle | Management of preterm birth best practices in prediction, prevention, and treatment Obstetrics and gynecology clinics of North America |
| title | Management of preterm birth best practices in prediction, prevention, and treatment |
| title_auth | Management of preterm birth best practices in prediction, prevention, and treatment |
| title_exact_search | Management of preterm birth best practices in prediction, prevention, and treatment |
| title_full | Management of preterm birth best practices in prediction, prevention, and treatment guest ed. Alice Reeves Goepfert |
| title_fullStr | Management of preterm birth best practices in prediction, prevention, and treatment guest ed. Alice Reeves Goepfert |
| title_full_unstemmed | Management of preterm birth best practices in prediction, prevention, and treatment guest ed. Alice Reeves Goepfert |
| title_short | Management of preterm birth |
| title_sort | management of preterm birth best practices in prediction prevention and treatment |
| title_sub | best practices in prediction, prevention, and treatment |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=024971822&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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