The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Preterm Birth: Causes, Consequences, and Prevention
9
Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth
ABSTRACT
The diagnosis and treatment of preterm labor is currently basedon an inadequate literature. Not only is there a paucity of welldesigned and adequately powered clinical trials, but there is incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor. To date, there is no singletest or sequence of assessment measures to accurately predictpreterm birth. Prevention of preterm birth has primarily focusedon the treatment of the woman with symptomatic preterm labor.Treatment has been directed toward the inhibition of contractions.This approach has not decreased the incidence of preterm birth butcan delay delivery long enough to allow administration of antenatal steroids and to transfer the mother and the fetus to an appropriate hospital, two interventions that have consistently been shownto reduce the rates of perinatal mortality and morbidity. Pretermbirth has historically not been emphasized in prenatal care, in thebelief that the majority of preterm births are due to social ratherthan medical or obstetric causes or are the appropriate result ofpathological processes that would benefit the mother or the infant,or both. Because preterm labor or premature rupture of membranesmay occur in response to conditions that threaten fetal or maternalwell-being, whether preterm birth is appropriately preventable is atopic that regularly influences clinical decision making. The ultimate goal of treatment for preterm labor is to eliminate or reduce