Premature birth primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Prevention of preterm birth

Recent research has identified possible methods to prevent preterm birth, pre-eclampsia/eclampsia, premature rupture of membranes, and preterm labor.

These include self-care methods to reduce infections, nutritional and psychological interventions, and the control of preterm birth risk factors (e.g. working long hours while standing on feet, carbon monoxide exposure, domestic abuse, and other factors). Injection with a form of progesterone (17 alpha-hydroxyprogesterone caproate) although the safety of this treatment for the fetus has been questioned by the FDA and its expert panel due to an associated increase in miscarriage and fetal death[1], the use of vaginal progesterone[2][3] ,taking fish oil supplements, and self-monitoring vaginal PH followed by yogurt treatment or Clindamycin treatment if the PH was too high all seem to be effective at reducing the risk of preterm birth.[4][5]

This research is quite new; however, doctors using these newer strategies have obtained preterm birth rates as low as 1 to 2%, compared to the 11 to 16% currently in the US.

References

  1. http://www.fda.gov/ohrms/dockets/ac/cder06.html#rhdac
  2. Fonseca et al. Progesterone and the risk of preterm birth among women with a short cervix. NEJM 2007; vol 357, no 5, pg 462-469.
  3. Romero R. Prevention of sponatneous preterm birth: the role of sonographic cervical length in identifying patients who may benefit from progesterone treatment. Ultrasound Obstet Gynecol 2007; 30: 675-686. http://www3.interscience.wiley.com/journal/99020267/home free download
  4. Lamont RF and Jaggat AN. Emerging drug therapies for preventing spontaneous preterm labor and preterm birth. Expert Opin Investig Drugs. 2007 16:337-45. PMID 17302528
  5. Hoyme UB and Saling E. Efficient prematurity prevention is possible by pH-self measurement and immediate therapy of threatening ascending infection. Eur J Obstet Gynecol Reprod Biol. 2004 115:148-53. PMID 15262346

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