Preterm Labor

Brooke Ersland, MD Reviewed 06/2022

BASICS

DESCRIPTION

Regular contractions occurring between 20 and 36 weeks and 6 days with either a change in effacement and cervical dilation or cervical dilation of ≥2cm on presentation.

EPIDEMIOLOGY

P...

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.
Hospitalization is necessary if the patient needs IV tocolysis.

MEDICATION

Tocolysis may allow time for interventions such as transfer to tertiary...

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

Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2019. NCHS Data Brief. 2020 Oct;(387):1-8.

American College of Obstetricians and Gynecologists' Committee on Practice Bul...

ADDITIONAL READING

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

CODES

ICD10

O60.03 Preterm labor without delivery, third trimester
O60.0 Preterm labor without delivery
O60.02 Preterm labor without delivery, second trimester
Z87.51 Personal history of pre-term labor
O60...

CLINICAL PEARLS

Treatment of preterm labor may delay delivery to facilitate short-term interventions.
Steroids improve neonatal outcomes.
Magnesium sulfate is recommended for neuroprotection for imminen...

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