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

2014 ◽  
Vol 25 (2) ◽  
pp. 134-145
Author(s):  
O. KAY ◽  
A. HUGHES ◽  
G. SAADE ◽  
P. BENNETT ◽  
V. TERZIDOU ◽  
...  
Keyword(s):  
Diurnal Variation ◽  
Preterm Labour ◽  
Preterm Births ◽  
Normal Process ◽  
Intrauterine Environment ◽  
Early Maturation ◽  
Preterm Premature Rupture ◽  
Labour Process ◽  
Inflammatory Processes ◽  
Oxytocin Antagonists

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.

scholarly journals ECOLOGICAL FEATURES OF MICROBIOCENOSIS OF THE SKIN OF MAMMARY GLANDS AND VAGINA IN PREGNANT WOMEN WITH THREAT OF PRETERM LABOR

2017 ◽  
Author(s):  
V. Ya. Ivankiv ◽  
I. M. Malanchyn ◽  
N. I. Tkachuk
Keyword(s):  
Pregnant Women ◽  
Mucous Membrane ◽  
Preterm Labour ◽  
Mammary Glands ◽  
Physiological Solution ◽  
Adequate Treatment ◽  
Ecological Features ◽  
Mother And Child ◽  
Sterile Medium ◽  
Inflammatory Processes

Background. The threat of preterm birth is one of the most topical issues in the world medicine. According to the statistics, from 12-13 to 25-35 % of all pregnancies end prematurely. One of the causes of preterm labour is chronic inflammatory processes of female genital organs and disorder of microbiocenosis. Timely diagnosis and adequate treatment will reduce the risk of premature labour and avoid perinatal loss.Objective. We examined and analysed the microflora of the skin of mammary glands and mucous membrane of vagina in healthy pregnant women and patients with threat of preterm labour.Materials and methods. The examination of the pregnant was conducted at the TRMPC “Mother and Child” in several stages. First of all, we rinsed the skin of mammary glands and smeared from mucous membrane the posterior vault of vagina with sterile swabs pre-moistened in physiological solution. After that, the tampons were placed in sterile tubes and delivered to laboratory. Sowing was carried out on Petri dishes with sterile medium: ZHSA, bloods MPA, Endo, Saburo, thioglycolic medium.Conclusions. As a result of the research we found saprophytic Gram-positive and Gram-negative microorganisms (in women with a physiological course of pregnancy). In pregnant women with preterm labour, there was the increase in the number of St. haemolyticus from 13% to 87%, appearance of representatives of pathogenic flora – St. aureus (in 20%).

Oxytocin antagonists in the treatment of preterm labour

2002 ◽  
Vol 13 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Mats Åkerlund
Keyword(s):  
United States ◽  
Postnatal Care ◽  
Developmental Delays ◽  
Preterm Labour ◽  
The United States ◽  
Social Burden ◽  
Annual Population ◽  
Oxytocin Antagonists ◽  
Early Preterm Birth ◽  
Main Complication

Despite substantial advances in pre- and postnatal care, the problem of preterm labour continues to be a significant medical, economic and social burden. Globally, it is estimated that 13 million babies are born preterm each year, but the incidence varies substantially between different countries and population groups. In the United States alone, approximately 11% of pregnancies, i.e. 380,000 cases annually are delivered after preterm labour and in Europe the overall incidence is believed to be approximately 6%, representing an annual population of 375,000. The main complication of very early preterm birth to the newborn is immaturity of different organs, in particular incomplete maturation of the lungs. However, a recent multi-centre surveillance study demonstrated that also modest degrees of prematurity are associated with developmental delays, implying that adequate intrauterine maturation of the fetus is vital to postnatal development.

scholarly journals Placental microbial–metabolite profiles and inflammatory mechanisms associated with preterm birth

2020 ◽  
Vol 74 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Kerry M Parris ◽  
Emmanuel Amabebe ◽  
Marta C Cohen ◽  
Dilly O Anumba
Keyword(s):  
Preterm Birth ◽  
Immune Responses ◽  
Inflammatory Responses ◽  
Preterm Labour ◽  
Subsequent Pregnancy ◽  
Potential Significance ◽  
Preterm Premature Rupture ◽  
Metabolic Products ◽  
Metabolite Profiles

There is growing emphasis on the potential significance of the placental microbiome and microbiome–metabolite interactions in immune responses and subsequent pregnancy outcome, especially in relation to preterm birth (PTB). This review discusses in detail the pathomechanisms of placental inflammatory responses and the resultant maternal–fetal allograft rejection in both microbial-induced and sterile conditions. It also highlights some potential placental-associated predictive markers of PTB for future investigation. The existence of a placental microbiome remains debatable. Therefore, an overview of our current understanding of the state and role of the placental microbiome (if it exists) and metabolome in human pregnancy is also provided. We critical evaluate the evidence for a placental microbiome, discuss its functional capacity through the elaborated metabolic products and also describe the consequent and more established fetomaternal inflammatory responses that stimulate the pathway to preterm premature rupture of membranes, preterm labour and spontaneous PTB.

STUDY OF MATERNALAND PERINATAL OUTCOME IN CASES OF PRETERM PREMATURE RUPTURE OF MEMBRANES

2021 ◽  
pp. 11-14
Author(s):  
Madhuri Rani ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Perinatal Outcome ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Preterm Births ◽  
Perinatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Preterm Premature Rupture

Background: Preterm premature rupture of membranes (PPROM) occurs in 3%to6% of pregnancies and is responsible for approximately one third of all preterm births. Aims & Objective: of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6days admitted in labour room of obs and gynae dept. of DMCH from January 2019 to April 2020. Material and Methods: It is hospital based prospective observational study of 100 patients of preterm premature rupture of membranes in between 28-36 weeks+6 days gestation with singleton pregnancy admitted in our tertiary care centre (Department of Obstetrics and Gynaecology, DMCH, Laheriasarai, Bihar). Results: In this study 42% patients went into spontaneous labour and 58% needed induction or augmentation. 68% patients had vaginal delivery and 23% required LSCS. The main indications for LSCS being malpresentation (26%) followed by foetal distress (22%). There was no maternal mortality; morbidity was found in 15% patients. Perinatal morbidity was seen in 40% and was mainly due to RDS, sepsis andhyperbilirubinaemia . Perinatal mortality was seen in 17% and was due to sepsis in 29.4%, RDS in 52.94% and birth asphyxia in 17.6%. Conclusion: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity & mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. Therefore management of PPROM requires accurate diagnosis and evaluation of the risks and benets of continued pregnancy or expeditious delivery. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benets of conservative management of preterm PROM at any gestation

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