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Objectives: To determine the obstetrical complications and perinatal outcomes of patients with recurrent episodes of preterm contractions (PTC) that eventually delivered at term compared to those who delivered preterm. Methods: A ...
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Objectives: To determine the obstetrical complications and perinatal outcomes of patients with recurrent episodes of preterm contractions (PTC) that eventually delivered at term compared to those who delivered preterm. Methods: A retrospective study evaluating pregnancy complications and adverse perinatal outcomes of patients with recurrent episodes of PTC (three or more) was conducted. A comparison was made between those who delivered preterm to those who eventually delivered at term. Results: Deliveries occurred between the years 1989 and 2009. During the study period, there were 1,897 singleton deliveries at term and 393 preterm singleton deliveries of patients who were previously hospitalized with PTCs. Patients who delivered at term were significantly more likely to be in their first pregnancy and to be primiparous. Patients in the study group were less likely to have had fertility treatments, a history of miscarriage, a higher incidence of one previous hospitalization but lower rates of multiple hospitalizations for PTC. Patients who delivered at term had a significantly lower rate of severe preeclampsia as well as cesarean delivery and a shorter hospital stay than those who delivered preterm. At term, an increased incidence of small for gestational age (SGA) neonates was noted compared to patients who delivered prematurely (10.07 vs. 5.6 %; P = 0.005). Conclusion: Patients with symptoms of preterm labor may require further surveillance, not only because of their risk to progress to preterm delivery, but also because they are at an increased risk for delivering an SGA neonate at term.
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Objective: To present the prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor and results after treatment. Material and Method: Forty-four, 50, and 56 pregnant women with threatened preterm, preterm, a...
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Objective: To present the prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor and results after treatment. Material and Method: Forty-four, 50, and 56 pregnant women with threatened preterm, preterm, and term labor, respectively were participated. Bacterial vaginosis was diagnosed by Amsel 's criteria. Treatment by metronidazole or clindamycin was used. A case record form recorded maternal age, obstetric history, gestational age at admission and delivery, examination data, the route of delivery, and the newborn birth weight and conditions. Results: The patients in threatened preterm labor group had significantly positive bacterial vaginosis when compared to those in the term labor group. Conclusion: Prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor were presented. The prevalence of bacterial vaginosis in both preterm labor groups was higher than in the term labor group.
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Objective: The aim of this study was to evaluate the incidence of cervical lacerations with cerclage removal planned before labor compared to after the onset of labor by a systematic review of published studies.
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When caring for women experiencing preterm labor and birth, nurses play a significant role as bedside experts, advocates, patient educators, and key members of the maternity care team. Enhanced expertise on clinical and profession...
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When caring for women experiencing preterm labor and birth, nurses play a significant role as bedside experts, advocates, patient educators, and key members of the maternity care team. Enhanced expertise on clinical and professional knowledge of preterm labor and birth is crucial in prevention and treatment. As preterm birth rates continue to rise, perinatal nurses as well-informed clinical experts have the opportunity to offer innovative education, holistic assessments, and communication through shared decision-making models. Educating pregnant women about early recognition of preterm labor warning signs and symptoms allows for timely diagnosis, interventions, and treatment. Informed and collaborative nursing practice improves quality of clinical care based on individualized interactions. A clinical review of preterm labor and preterm birth is presented for perinatal nurses.
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Abstract Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone,...
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Abstract Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes. Future research on preterm birth interventions should include long-term follow-up of the children, ideally with similar outcome measures to allow for future meta-analyses.
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Objective To compare first-stage labor patterns in women in preterm labor to those in labor at term. Study Design We performed a retrospective cohort study of consecutive women admitted from 2004 to 2008 with viable (≥24 weeks) v...
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Objective To compare first-stage labor patterns in women in preterm labor to those in labor at term. Study Design We performed a retrospective cohort study of consecutive women admitted from 2004 to 2008 with viable (≥24 weeks) vertex singleton gestations who reached the second stage of labor. Labor curves for preterm and term labor were created using a repeated-measures analysis with polynomial modeling. Interval-censored regression was used to estimate and compare median time of progression of labor. Multivariable analyses were performed to adjust for smoking, obesity (body mass index ≥30), induction, and nulliparity. The adjusted model was stratified by parity and induction of labor. Results Of 5,612 consecutive births, 224 were preterm (<37 weeks) and 5,388 were term (≥37 weeks). Preterm first-stage labor progressed significantly faster than term labor (median time 4 to 10 cm: 3.3 hours versus 4.5 hours, p < 0.01). When stratified by parity, preterm labor progressed significantly more rapidly than term labor in both nulliparous and multiparous women (median time 4 to 10 cm: 3.7 hours versus 4.9 hours [p = 0.04] in nulliparous women and 2.5 hours versus 4.3 hours [p = 0.01] in multiparous women). Conclusion Women in preterm labor progress more rapidly through the first stage of labor than women at term.
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Objective: To determine the relationship between preterm labor and delivery, and the pH and buffer capacity of vaginal secretions. Methods: Between January 1, 2009 and March 31, 2012, two cohorts of patients at 22-36 weeks of preg...
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Objective: To determine the relationship between preterm labor and delivery, and the pH and buffer capacity of vaginal secretions. Methods: Between January 1, 2009 and March 31, 2012, two cohorts of patients at 22-36 weeks of pregnancy were enrolled in a prospective cohort study at Nara Medical University Hospital, Japan. Patients experiencing preterm contractions and a control group of patients experiencing normal pregnancies were included. The pH and buffer capacity of vaginal secretions were measured and compared. Results: Of the 237 patients enrolled, 48 (20.3%) were experiencing symptoms of preterm labor and 189 (79.7%) were included in the control group. The pH was higher (P < 0.001) and the buffer capacity was lower (P = 0.0135) in the vaginal secretions of the patients experiencing preterm contractions compared with the control group. There was no difference in the pH and buffer capacity of the vaginal secretions of symptomatic patients who would experience preterm delivery and those who would not. Receiver operating characteristic curve analyses demonstrated that vaginal-secretion pH and buffer capacity could differentiate between patients experiencing preterm contractions and those not, but could not differentiate between patients who would experience preterm delivery and those who would not. Conclusion: Vaginal-secretion pH and buffer capacity could be useful in diagnosing preterm labor; further studies are needed to determine potential practical diagnostic criteria. (C) 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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Abstract In the United States, the generally accepted indication for tocolytic therapy centers on suppression of preterm labor. This may be in the form of preventative therapy with progesterone in women with prior spontaneous pret...
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Abstract In the United States, the generally accepted indication for tocolytic therapy centers on suppression of preterm labor. This may be in the form of preventative therapy with progesterone in women with prior spontaneous preterm birth or as an acute intervention to suppress established uterine contractions associated with cervical change occurring at less than 37 weeks gestation. This article seeks to apply this perspective to tocolytic therapy. Here, we provide a review of current tocolytic options and what the last decade of discovery has revealed about the regulation of myometrial excitability and quiescence. Moving forward, we must incorporate the emerging molecular data that is amassing in order to develop novel and effective tocolytic therapeutic options to prevent preterm labor and spontaneous preterm birth (sPTB).
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Preterm birth occurs in 12% of all births in the United States. Preterm labor precedes approximately half of these births. Tocolysis is used in the short term to prolong pregnancy long enough to administer corticosteroids and/or f...
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Preterm birth occurs in 12% of all births in the United States. Preterm labor precedes approximately half of these births. Tocolysis is used in the short term to prolong pregnancy long enough to administer corticosteroids and/or facilitate transfer to a tertiary care center. A number of agents have been used for this therapy, which will be discussed in the following chapter.
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