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RECENT ADVANCES IN THE PREVENTION AND TREATMENT OF PRETERM LABOUR: OXYTOCIN ANTAGONISTS AND THE SILICONE (ARABIN) PESSARY

Published online by Cambridge University Press:  17 March 2015

O. KAY ,
A. HUGHES ,
G. SAADE ,
P. BENNETT ,
V. TERZIDOU  and
S. THORNTON
O. KAY*
Affiliation:
Barts and the London School of Medicine and Dentistry, E1 2AD, UK.
A. HUGHES
Affiliation:
University of Exeter Medical School, Barrack Road, Exeter EX2 5DW, UK.
G. SAADE
Affiliation:
University of Texas Medical Branch, Galveston, TX.
P. BENNETT
Affiliation:
Institute for Reproductive and Developmental Biology, Imperial College London W12 0NN, UK.
V. TERZIDOU
Affiliation:
Institute for Reproductive and Developmental Biology, Imperial College London W12 0NN, UK.
S. THORNTON
Affiliation:
University of Exeter Medical School, Barrack Road, Exeter EX2 5DW, UK.
*
Olivia Kay, Barts and the London School of Medicine and Dentistry, Garrod Building, Turner Street, Whitechapel, London, E1 2AD, UK. Email: O.Kay@smd12.qmul.ac.uk
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Extract

Preterm birth may be spontaneous or medically indicated for maternal or fetal reasons. Around 20–25% of preterm births (PTB) follow preterm premature rupture of the membranes (PPROM), however the cause of preterm labour is often unknown. It may represent early maturation and activation of the normal labour process or it may be precipitated by pathological causes. The normal process of labour has a diurnal variation with more deliveries occurring at night. Evidence demonstrating that the diurnal variation persists in preterm deliveries suggest that at least a proportion are due to early maturation of the normal process and the logical assumption is that these may be amenable to prevention or effective treatment. Whatever the cause of preterm delivery, there appears to be a common pathway resulting in activation of inflammatory processes. It is important to distinguish the physiological and pathological causes of preterm labour and not to assume that all inflammation is pathological. The distinction is clinically important since pathological causes may be associated with an adverse intrauterine environment, which would be a contraindication to delaying delivery.

Type
Review Article
Information
Fetal and Maternal Medicine Review , Volume 25 , Issue 2 , May 2014 , pp. 134 - 145
Copyright
Copyright © Cambridge University Press 2015 

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