title: Modern management of preterm labour.
abstract: Preterm birth is the leading cause of neonatal morbidity and mortality. Cervical insufficiency is not an all or nothing phenomenon but a continuous variable which can lead to preterm deliveries at different gestational ages. The relationship between shortened cervical length and spontaneous preterm birth is consistent in several studies. Shortened cervical length can be diagnosed by transvaginal ultrasonography and treated by transvaginal cervical cerclage (TCC). A nomenclature to the different stages of prevention, as primary, secondary and tertiary was suggested to facilitate comparison of studies. Apart from cervical cerclage, the most widely used tocolytics are betamimetics. Although they have been shown to delay delivery, betamimetics have not been shown to improve perinatal outcome, and they have a high frequency of unpleasant and even fatal and maternal side effects. There is growing interest in calcium channel blockers which appear to be more effective than beta-sympathomimetic drugs and have few side-effects.
authors.affiliation: Lyell McEwin Hospital, University of Adelaide.
authors.forename: Gus
authors.initials: G
authors.lastname: Dekker
authors.forename: Sietske
authors.initials: S
authors.lastname: Althuisius
authors.forename: Dimitri
authors.initials: D
authors.lastname: Papatsonis
authors.forename: Nares
authors.initials: N
authors.lastname: Sukcharoen
mesh_terms: D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D023802:Cerclage, Cervical; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D015149:Tocolytic Agents / Q000627:therapeutic use*; D014463:Ultrasonography; D002581:Uterine Cervical Incompetence / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy
chemical_list: D000318:Adrenergic beta-Agonists; D002121:Calcium Channel Blockers; D015149:Tocolytic Agents