Preterm birth is defined as delivery before 37 weeks of gestation. It is the leading cause of neonatal death and infant mortality, often as a result of respiratory distress syndrome due to immature lung development . Babies who survive are also at high risk of neurological disability and can experience further breathing, feeding, digestive, visual, and hearing problems. Observational studies have found that a prior history of preterm birth significantly
Births that follow spontaneous preterm labor (PTL) and preterm premature rupture of membranes (pPROM) are together designated as spontaneous preterm births. Spontaneous preterm births account for ~70% of all premature deliveries, where the remaining 30% are indicated as a result of maternal or fetal infection . Of those births classified as spontaneous preterm births, 64% are the result of preterm labor (PTL) and 36% are are the result of preterm premature rupture of membranes (pPROM).
PTL is defined as the onset of active contractions at a preterm (<37 weeks) gestation. Common symptoms suggestive of PTL include: uterine activity, abdominal discomfort, change in vaginal discharge, bleeding and/or cramping. Traditional evaluation includes uterine activity monitoring and evaluation of the cervix . The exact mechanism(s) of preterm labor is largely unknown, but is believed to include: decidual hemorrhage, (e.g. abruption, mechanical factors such as uterine over-distension from multiple gestation or polyhydramnios), cervical incompetence (e.g. trauma, cone biopsy), uterine distortion, cervical inflammation, drug abuse, smoking, alcohol consumption, among others. (Lopes M (2013) Managing Costs in High Risk Obstetrics: The Value of Technology that Improves Diagnostic Accuracy.)
Last date updated on July, 2014