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Preterm labor

Key sources
The following summarized guidelines for the evaluation and management of preterm labor are prepared by our editorial team based on guidelines from the European Consensus Group on Respiratory Distress Syndrome (ECG-RDS 2023), the Society of Obstetricians and Gynaecologists of Canada (SOGC 2022), the American College of Obstetricians and Gynecologists (ACOG 2021; 2020; 2017; 2016), and the World Health Organization (WHO 2015).
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Guidelines

1.Diagnostic investigations

Risk assessment: as per ECG-RDS 2023 guidelines, consider obtaining cervical length and accurate biomarker measurements to prevent unnecessary use of tocolytic drugs and/or antenatal corticosteroids in patients with symptoms of preterm labor.
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2.Medical management

Setting of care: transfer pregnant females at high risk of preterm birth < 28-30 weeks of gestation to perinatal centers with experience in the management of respiratory distress syndrome.
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3.Therapeutic procedures

Mode of delivery: do not perform routine C-section to improve preterm infant outcomes, regardless of cephalic or breech presentation.
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4.Preventative measures

Progesterones: as per ECG-RDS 2023 guidelines, administer vaginal progesterone to increase gestational age at delivery and reduce perinatal mortality and morbidity in females with singleton pregnancy and a short cervix in mid-pregnancy or previous preterm birth.
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