Preterm Labor

Kara M. Coassolo, MD and John C. Smulian, MD, MPH Reviewed 06/2019

BASICS

DESCRIPTION

Contractions occurring between 20 and 36 weeks’ gestation at a rate of 4 in 20 minutes or 8 in 1 hour with at least one of the following: cervical change over time or dilation ≥2 cm

EPIDEMIOLOGY

DIAGNOSIS

Diagnosis is generally based on a combination of significant cervical changes (such as dilation, effacement) with regular contractions. However, there is no single test that will reliably di...

TREATMENT

GENERAL MEASURES

Treat underlying risk factors (e.g., antibiotics for infections, hydration for dehydration).
Liquids only or NPO if delivery is imminent
Hospitalization is necessary if the pat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Weekly office visits with contraction monitoring, cervical checks, or cervical US if at high risk for recurrence
Routine use of maintenance tocol...

REFERENCES

Purisch SE, Gyamfi-Bannerman C. Epidemiology of preterm birth. Semin Perinatol. 2017;41(7):387–391. [View Abstract on OvidMedline]

Berghella V, Rafael TJ, Szychowski JM, et al. Cercl...

ADDITIONAL READING

American College of Obstetricians and Gynecologists Committee on Obstetric Practice, Society for Maternal-Fetal Medicine. Committee Opinion No. 455: magnesium sulfate before anticip...

CODES

ICD10

O60.00 Preterm labor without delivery, unspecified trimester
O60.02 Preterm labor without delivery, second trimester
O60.03 Preterm labor without delivery, third trimester
O60.10X0 Preterm lab...

CLINICAL PEARLS

Treatment of preterm labor may delay delivery to facilitate short-term interventions.
Steroids improve neonatal outcomes.
Progesterone therapy can prevent recurrence of preterm birth in ...

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