Preterm Labor and Its Management

Preterm labor is defined as the onset of regular uterine contractions leading to cervical changes before 37 completed weeks of gestation. It is one of the major causes of neonatal morbidity and mortality.

 
1. Identification of Risk Factors
Recognizing women at risk is essential for prevention and early intervention.
• Previous preterm birth
• Multiple pregnancy (twins/triplets)
• Infections (urinary or genital tract infections)
• Short cervix or cervical incompetence
• Poor maternal nutrition
• Smoking, stress, or substance abuse
• Placental abnormalities (abruption or previa)

2. Use of Tocolytics
Tocolytic drugs are used to delay preterm labor for 24–48 hours to allow administration of corticosteroids for fetal lung maturity.
Common tocolytics include:
• Nifedipine (calcium channel blocker)
• Magnesium sulfate (for neuroprotection and relaxation of uterus)
• Indomethacin (NSAID, short-term use)
• Atosiban (oxytocin receptor antagonist)

3. Neonatal Care
Proper neonatal care is crucial for preterm infants due to their underdeveloped organs.
• Corticosteroids (e.g., betamethasone) to enhance lung maturity before birth.
• NICU admission for temperature regulation, feeding support, and infection prevention.
• Respiratory support (oxygen or mechanical ventilation if required).
• Monitoring for complications like respiratory distress syndrome, hypoglycemia, or jaundice.

Conclusion
Early detection, prompt use of tocolytics, and specialized neonatal care are vital to improving survival and outcomes in preterm labor cases.