Evaluation and Management of Preterm Labor and Birth

A Comprehensive Guide to the Literature for Personal Injury Lawyers

Publisher: Medifocus Legal
Publication Date: September 20, 2022
Number of Pages: 110
Preterm birth is defined as birth that occurs between 20 and 37 weeks of gestation. It's estimated that preterm birth accounts for about 10% of all births worldwide, which represents approximately 13 million births. About 50% of preterm deliveries are the result of spontaneous labor with intact membranes while an additional 25% are associated with premature rupture of membranes (PROM).

Factors that increase the risk of preterm labor include:

• Previous preterm birth.
• Shortened cervix.
• Multiple gestation.
• Vaginal bleeding due to placental abruption or placent previa.
• Infections such as bacterial vaginosis or Chlamydia infection.
• Lifestyle factors including low pregnancy weight, smoking, and dietary deficiency.

Neonates born preterm are at increased risk of complications attributed to immaturity of multiple organ systems. They are also at an increased risk for neurodevelopmental disorders such as cerebral palsy, intellectual disabilities, and vision/hearing disorders. It is, therefore, important for women who present with signs and symptoms of preterm labor to be evaluated and managed in a facility that is equipped with a neonatal intensive care unit (NICU).

The initial evaluation of patients who present with preterm contractions consists of a thorough history, assessment of membrane integrity, monitoring for signs of fetal distress, and looking for evidence of infection. Only 30% to 60% of women who present with preterm contractions actually go on to deliver prematurely.

The management of women who are confirmed to be in preterm labor depends on the gestation age of presentation, the in utero status of the fetus, as well as the overall health status of the mother. In general, the management options for preterm labor include:

• Bed rest either at home or in hospital.
• Tocolytic medications to slow or completely arrest contractions.
• Cervical cerclage to stich the cervix closed.
• Antibiotic prophylaxis against Group B Streptococcus infection.
• Administration of corticosteroids to promote maturation of the fetal lungs in the event of premature delivery.
• Delivery of the preterm infant if contractions cannot be arrested or if there is evidence of fetal distress.

The MediFocus Literature Guide to Evaluation and Management of of Preterm Labor and Birth is a comprehensive roadmap to the medical literature for personal injury attorneys who may be required to litigate cases of premature labor and birth that result in a medical negligence claim. This unique Literature Guide includes 125 hand-selected references of articles published in peer-reviewed journals with links to the abstracts of the articles.FREE online access to the full-text of 106 of these articles is also included.
Evaluation and Management of Preterm Labor and Birth is a one-of-a-kind literature reference Guide that includes:

• A comprehensive bibliography of 126 journal article references indexed in MEDLINE published in well respected medical and scientific journals.
• Online access to the abstracts (summaries) of the articles.
• Online access to the free full-text version of 106 articles.
• Links to full-text sources of other articles that are available for purchase directly from individual journal publishers.
• A unique "Author Directory" consisting of the names and institutional affiliations of experts who have published and have specialized knowledge about Evaluation and Management of Preterm Labor and Birth. The "Author Directory" is a valuable resource for quickly identifying and locating experts for case reviews, opinions, and testimony.

Select examples of topics that are covered by the articles referenced in this Guidebook include:

• Antenatal corticosteroids in preterm small-for-gestational age infants: a systematic review and meta-analysis.
• Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview.
• Screening for spontaneous preterm birth and resultant therapies to reduce neonatal morbidity and mortality: A review. Semin Fetal Neonatal Med.
• Vaginal progesterone for preventing preterm birth and adverse perinatal outcomes in singleton gestations with a short cervix: a meta-analysis of individual patient data.
• Risk of spontaneous preterm birth in singleton pregnancies conceived after IVF/ICSI treatment: meta-analysis of cohort studies.
• Current perspectives on the use of fetal fibronectin testing in preterm labor diagnosis and management.
• Predicting preterm birth: Cervical length and fetal fibronectin.
• Counselling about the Risk of Preterm Delivery: A Systematic Review.
• Cervical stitch (cerclage) for preventing preterm birth in singleton pregnancy.
• Deliver or wait with late preterm membrane rupture?
• Tocolysis for inhibiting preterm birth in extremely preterm birth, multiple gestations and in growth-restricted fetuses.
• Guidelines for the Management of Extremely Premature Deliveries: A Systematic Review.
• Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity.
• Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth.
• Bed rest in singleton pregnancies for preventing preterm birth.
• Prediction of preterm birth in twin gestations using biophysical and biochemical tests.
• Caesarean section versus vaginal delivery for preterm birth in singletons.
• Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour.
• The consequences of chorioamnionitis: preterm birth and effects on development.
• ACOG practice bulletin no. 127: Management of preterm labor.

The MediFocus Literature Guide on Evaluation and Management of Preterm Labor and Birth is available in two formats:
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