Preterm labor is defined as regular rhythmic contractions of the uterus resulting in changes in the cervix that start before 37 weeks of pregnancy. Preterm births are classified according to gestational age at delivery. The strongest risk factors for idiopathic preterm labor are low socioeconomic status and previous preterm delivery. Intrauterine infection plays a major role in the genesis of preterm labor. Diagnosis of preterm labor is made when the symptoms of preterm labor are associated with cervical changes. Investigations specific for diagnosis of preterm labor include transvaginal ultrasonography, fetal fibronectin, maturity amniocentesis, PAMG-1, and cervicovaginal cultures. Cervical cerclage and progesterone supplementation are commonly used for prevention of preterm births in high-risk populations. Management for women with established preterm labor includes administration of steroids for pulmonary maturity, magnesium sulfate for neuroprotection, and tocolytics which give time for these drugs to act. Vaginal delivery is allowed in cephalic presentations; non-cephalic presentations are delivered by Caesarean section. Best neonatal care available locally should be provided to these preterm infants, as they are prone to multisystem complications.
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