Preterm labour: association between labour physiology, tocolysis and prevention.
BACKGROUND
In developed countries, preterm birth is the major cause of perinatal morbidity, mortality and the most important public health problem in the obstetric field. In the past decades, an increasing trend has been observed regardless of the great efforts focussed on the improvement of our understanding of the physiopathological mechanisms behind preterm labour (PTL) and the improvement in the use of tocolytic drugs.


METHODS
In this review, the authors focus on some points of the physiopathology of labour in order to understand the rationality behind the different management approaches developed for the PTL syndrome.


CONCLUSIONS
There is a need to develop new tools for the treatment of patients with PTL. Research focussed on improving tocolysis, the physiology of labour and pathological processes involved in PTL would afford new approaches for the treatment of PTL, allowing clinicians to provide integrative solutions for this multifactorial disease. Recently, the prophylactic use of progesterone pessary and cerclage in women with high risk of premature labour has been reported to reduce the incidence of premature births and improve neonatal outcomes. These results highlight the importance of prediction models in order to establish preventative strategies early in pregnancy.
Universidad de Los Andes, Department of Obstetrics & Gynaecology and Laboratory of Reproductive Biology, Faculty of Medicine , Santiago , Chile.
Sebastián E
SE
Illanes
Alejandra
A
Pérez-Sepúlveda
Gregory E
GE
Rice
Murray D
MD
Mitchell
D000818:Animals; D017326:Clinical Trials, Phase III as Topic; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000503:physiopathology* / Q000517:prevention & control*; D011247:Pregnancy; D015145:Tocolysis / Q000379:methods*; D015149:Tocolytic Agents / Q000494:pharmacology* / Q000627:therapeutic use*
D015149:Tocolytic Agents
calcium regulation; labour physiology; preterm labour; preterm labour prevention; tocolysis