Table of contents

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 Endocrine Society (ES 2024), 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 ...
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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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Medical management

Setting of care: as per ECG-RDS 2023 guidelines, 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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  • Corticosteroids

  • Tocolytics

  • Antibiotics

Therapeutic procedures

Mode of delivery: as per WHO 2015 guidelines, do not perform routine C-section to improve preterm infant outcomes, regardless of cephalic or breech presentation.

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  • Umbilical cord clamping

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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  • Bed rest

  • Vitamin D supplementation