Document Detail

Current concepts in the management of preterm labour.
MedLine Citation:
PMID:  2699676     Owner:  NLM     Status:  MEDLINE    
Prematurity remains the major cause of perinatal mortality and morbidity in Singapore. Prevention of prematurity is therefore of vital importance. Epidemiological methods using historical variables have been superseded by ongoing pregnancy factors including work, exercise and cervical dilatation. PGF levels bear a positive correlation to duration and cervical dilatation but are not elevated at onset. PGE production is high in ruptured membranes. Progesterone and relaxin are potent inhibitors before labour. Infection must play an important role in developing countries as organisms not thought of to be pathogenic produce phospholipase A2. For prediction, cervical assessment and topography are proving important. In view of the dangerous side effects of tocolytic drugs and the difficulty in diagnosis of preterm labour, absence of fetal breathing is a useful index of progressive labour. In those labours that are advanced, whether to allow vaginal delivery or not will be determined by the presentation and condition of the fetus. The complementary role of other drugs to reduce morbidity from hyaline membrane disease and intraventricular haemorrhage is being studied. Fetal acidosis should be avoided and the infant delivered without trauma under optimal circumstances. In utero transfer to a facility with neonatal intensive care carries a better prognosis for the baby.
R L TambyRaja
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Singapore medical journal     Volume:  30     ISSN:  0037-5675     ISO Abbreviation:  Singapore Med J     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-06-14     Completed Date:  1990-06-14     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  0404516     Medline TA:  Singapore Med J     Country:  SINGAPORE    
Other Details:
Languages:  eng     Pagination:  578-83     Citation Subset:  IM    
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MeSH Terms
Delivery, Obstetric
Fetal Monitoring
Infant Mortality
Infant, Newborn
Obstetric Labor, Premature / prevention & control*
Oxytocin / administration & dosage
Tocolytic Agents / pharmacology
Uterine Contraction / drug effects
Reg. No./Substance:
0/Tocolytic Agents; 50-56-6/Oxytocin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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