Review Article
Volume 9 Issue 2 - 2020
Management of Premature Labor
Fayzah Ahmed Andegani1*, Kamal Mohammad Khan2, Salma Ali Almagaadi2, Mohammed Sami Basubrain2, Abdullah Nasser M Alotaibi3, Abdulrahman Adnan Abukhashaba4, Feras Fauzy Allehyani5, Noha Jameel Alhamawi2, Nouf Obaid Alhazmi6, Maha Hamed Rabea Altowairqi7, Bayan Yahya Almuzaini2, Sara Nabeel Mermulla4 and Abdullah Abdulrahman Alsaeed8
1King Abdulaziz Hospital, Jeddah, Saudi Arabia
2Ibn Sina National College, Saudi Arabia
3Prince Sattam Bin Abdulaziz University, Saudi Arabia
4King Abdulaziz Hospital, Makkah, Saudi Arabia
5Umm al-Qura University, Saudi Arabia
6Taibia University, Saudi Arabia
7Ohud Hospital, Saudi Arabia
8Almalaz Primary Health Care, Saudi Arabia
*Corresponding Author: Fayzah Ahmed Andegani, King Abdulaziz Hospital, Jeddah, Saudi Arabia.
Received: January 03, 2020; Published: January 18, 2020


Introduction: Preterm birth is defined as a delivery before 37 weeks of gestation. It affects about 5 - 18% of pregnancies. Preterm birth is a leading cause of neonatal death, it is also the second most common cause of death in children below 5 years of age. Preterm infants have a higher risk of short-term complications (due to the immaturity of their organ systems) and neuro-developmental disorders such as intellectual disability, vision and/or hearing impairment and also cerebral palsy. Disability-adjusted life years, which is the number of years of life lost due to illness, disability or an early death, has preterm birth as its leading cause. The cost of health care related to this in the United States is about $26.2 billion annually. Most common cause of preterm births is idiopathic. Other causes include fetal factors, placental and uterine factors and maternal chronic diseases. 70% of preterm births in the US are idiopathic and the remaining are mostly related to pre-eclampsia (50%), fetal distress (25%) or placental abruption (25%).

Objectives: In this review, we will discuss the recent advances in management of premature labor.

Methodology: We did a systematic search for management of preterm labor using PubMed search engine ( and Google Scholar search engine ( All relevant studies were retrieved and discussed. We only included full articles.

Conclusion: Preterm labor is a multifactorial condition accompanied with a great risk of morbidity and mortality. direction towards Prevention is by identifying women at risk and comprises screening and treatment for bacterial vaginosis, introducing cerclage in appropriate women and giving progesterone prophylaxis. The management of established preterm labor must be directed towards identifying those women in whom a delay in delivery is likely to be helpful and those in whom it may be harmful in terms of the outcome in neonates or infants. 

Keywords: Preterm Labor; Premature Birth; Intrauterine Infection; Premature Rupture of Birth


  1. Liu L., et al. “Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000”. Lancet 379 (2012): 2151-2161.
  2. Mwaniki MK., et al. “Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review”. Lancet 379 (2012): 445-452.
  3. Meis PJ., et al. “The preterm prediction study: risk factors for indicated preterm births. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development”. American Journal of Obstetrics and Gynecology 178 (1998): 562-567.
  4. O'Brien JM and Lewis DF. “Prevention of preterm birth with vaginal progesterone or 17-alpha-hydroxyprogesterone caproate: a critical examination of efficacy and safety”. American Journal of Obstetrics and Gynecology 214 (2016): 45-56.
  5. Goldenberg RL., et al. “Epidemiology and causes of preterm birth”. Lancet 371 (2008): 75-84.
  6. Gotsch F., et al. “The fetal inflammatory response syndrome”. Clinical Obstetrics and Gynecology 50 (2007): 652-683.
  7. Newnham JP., et al. “Strategies to prevent preterm birth”. Frontiers in Immunology 5 (2014): 584.
  8. Son M., et al. “A universal mid-trimester transvaginal cervical length screening program and its associated reduced preterm birth rate”. American Journal of Obstetrics and Gynecology 214 (2016): 365.e1-5.
  9. Dziadosz M., et al. “Uterocervical angle: a novel ultrasound screening tool to predict spontaneous preterm birth”. American Journal of Obstetrics and Gynecology 215 (2016): 376.e1-7.
  10. Oturina V., et al. “Assessment of cervical elastography strain pattern and its association with preterm birth”. Journal of Perinatal Medicine 45 (2017): 925-932.
  11. Cobo T., et al. “Impact of microbial invasion of amniotic cavity and the type of microorganisms on short-term neonatal outcome in women with preterm labor and intact membranes”. Acta Obstetricia et Gynecologica Scandinavica 96 (2017): 570-579.
  12. Mendz GL., et al. “Bacterial aetiological agents of intra-amniotic infections and preterm birth in pregnant women”. Frontiers in Cellular and Infection Microbiology 3 (2013): 58.
  13. Capoccia R., et al. “Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes”. Current Opinion in Infectious Diseases 26 (2013): 231-240.
  14. Payne MS., et al. “Ureaplasma parvum genotype, combined vaginal colonisation with Candida albicans, and spontaneous preterm birth in an Australian cohort of pregnant women”. BMC Pregnancy Childbirth 16 (2016): 312.
  15. Donders GG., et al. “Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy”. BJOG: An International Journal of Obstetrics and Gynaecology 116 (2009): 1315-1324.
  16. Leitich H., et al. “Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis”. American Journal of Obstetrics and Gynecology 189 (2003): 139-147.
  17. Lamont RF. “Advances in the Prevention of Infection-Related Preterm Birth”. Frontiers in Immunology 6 (2015): 566.
  18. Gomez R., et al. “Antibiotic administration to patients with preterm premature rupture of membranes does not eradicate intra-amniotic infection”. Journal of Maternal-Fetal and Neonatal Medicine 20.2 (2007): 167-173.
  19. Keelan JA., et al. “A New, Potent, and Placenta-Permeable Macrolide Antibiotic, Solithromycin, for the Prevention and Treatment of Bacterial Infections in Pregnancy”. Frontiers in Immunology 7 (2016): 111.
  20. Griffin C. “Probiotics in obstetrics and gynaecology”. Australian and New Zealand Journal of Obstetrics and Gynaecology 55 (2015): 201-209.
  21. Kiss H., et al. “Prospective randomised controlled trial of an infection screening programme to reduce the rate of preterm delivery”. British Medical Journal 329 (2004): 371.
  22. Farr A., et al. “Routine Use of an Antenatal Infection Screen-and-Treat Program to Prevent Preterm Birth: Long-Term Experience at a Tertiary Referral Center”. Birth 42 (2015): 173-180.
  23. Jarde A., et al. “Effectiveness of progesterone, cerclage and pessary for preventing preterm birth in singleton pregnancies: a systematic review and network meta-analysis”. BJOG: An International Journal of Obstetrics and Gynaecology 124 (2017): 1176-1189.
  24. Romero R., et al. “Vaginal progesterone decreases preterm birth </= 34 weeks of gestation in women with a singleton pregnancy and a short cervix: an updated meta-analysis including data from the OPPTIMUM study”. Ultrasound in Obstetrics and Gynecology 48 (2016): 308-317.
  25. Norman JE., et al. “Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial”. Lancet 387 (2016): 2106-2116.
  26. Romero R., et al. “Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix: an updated meta-analysis of individual patient data”. Ultrasound in Obstetrics and Gynecology 49 (2017): 303-314.
  27. Sinclair JC. “Meta-analysis of randomized controlled trials of antenatal corticosteroid for the prevention of respiratory distress syndrome: discussion”. American Journal of Obstetrics and Gynecology 173 (1995): 335-344.
  28. French NP., et al. “Repeated antenatal corticosteroids: size at birth and subsequent development”. American Journal of Obstetrics and Gynecology 180 (1999): 114-121.
  29. Kenyon SL., et al. “Broad-spectrum antibiotics for preterm, prelabour rupture of fetal membranes: the ORACLE I randomised trial. ORACLE Collaborative Group”. Lancet 357 (2001): 979-988.
  30. Gyetvai K., et al. “Tocolytics for preterm labor: a systematic review”. Obstetrics and Gynecology 94 (1999): 869-877.
  31. King JF., et al. “Calcium channel blockers for inhibiting preterm labour”. Cochrane Database of Systematic Reviews (2003): CD002255.
Citation: Ahmed Andegani., et al. “Management of Premature Labor”. EC Gynaecology 9.2 (2020): 01-08.

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