title: Prevention of periviable birth: bed rest, tocolysis, progesterone, and cerclage.
abstract: The periviable period is associated with a rapid improvement in both mortality and morbidity with increasing gestational age. Therapies that can prolong gestation have the potential for markedly improving outcome compared to later in pregnancy. The therapies commonly prescribed in order to prolong gestation include bed rest, tocolysis, progesterone, and cerclage. Although these therapies are used to prevent preterm birth throughout gestation, their impact on perinatal outcome during the periviable period remains largely unknown. These therapies are discussed relative to the periviable period exploring available data and possible impact on perinatal outcome. Studies specifically evaluating therapeutic interventions during the periviable period are lacking.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Case Western Reserve University, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109. Electronic address: echien@metrohealth.org.
authors.forename: Edward K
authors.initials: EK
authors.lastname: Chien
mesh_terms: D001510:Bed Rest / Q000379:methods; D023802:Cerclage, Cervical / Q000379:methods; D005260:Female; D005328:Fetal Viability; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011374:Progesterone / Q000627:therapeutic use*; D011372:Progestins / Q000627:therapeutic use*; D013997:Time Factors; D015145:Tocolysis / Q000379:methods
chemical_list: D011372:Progestins; D011374:Progesterone
keywords: Bedrest; Cerclage; Periviable birth; Progesterone; Tocolysis; Treatment