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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

1
Purisch SE, Gyamfi-Bannerman C. Epidemiology of preterm birth. Semin Perinatol.  2017;41(7):387–391. [View Abstract on OvidMedline]
2
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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