Preterm birth (delivery between 20w0d to 36w6d) is the leading cause of neonatal mortality, affecting 12% of all deliveries, with 50% preceded by preterm labor. Preterm labor includes regular uterine contractions with cervical dilation, effacement or both. Preterm birth accounts for a significant burden of poor neonatal outcomes, including 70% of neonatal deaths, 36% of infant deaths, and up to 50% of long-term neurological impairment with a heavy financial burden. Of note, half of all patients hospitalized for preterm labor will deliver at term.
Tests to Stratify Risks of Preterm Birth
Note: Women with preterm contractions without cervical change generally should not be treated with tocolytics
Note: First line agents for tocolysis are beta-adrenergic agonists, calcium channel blockers or NSAIDs
Note: If magnesium sulfate is being used for neuroprotection, ACOG recommends that beta-adrenergic receptor agonists and calcium-channel blockers “should be used with caution in combination with magnesium sulfate for this indication” | <32 weeks, indomethacin is a potential option for tocolysis
Note: For more on antenatal steroids and the SMFM guidance on late preterm steroids, see ‘Related ObG Topics’ below
ACOG Practice Bulletin 171: Management of Preterm Labor
ALPS Trial: Antenatal Betamethasone for Women at Risk for Late Preterm Delivery
Are you an
Get specially curated clinical summaries delivered to your inbox every week for free
Please log in to ObGFirst to access this page
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan
You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site