The irritable uterus: a risk factor for preterm birth?

Article Abstract:

Irritable uterus is a risk factor for preterm labor. Irritable uterus is the condition of frequent, painful contractions that do not result in cervical effacement or dilation. A group of 17,186 patients at high risk for preterm birth received education about signs and symptoms and wore a home uterine contraction monitoring device for two hours daily. Among this group, 2637 women had uterine irritability. The incidence of preterm labor was 19% compared with 11% among the general population. Moreover, women who experienced preterm labor were 2.5 times more likely to give birth before 34 weeks gestation compared with women other risk factors. This may be because irritable uterus is often preventatively treated with contraction-suppressing drugs, which then fail to work to stop preterm labor because the uterus has become desensitized. It may also be that because contractions are painful, women consider true labor to be another false alarm and do not get medical attention until labor is too advanced to stop.

Risk factors, Premature labor, Uterus, Uterine contractions

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The case for trial of labor in the patient with a prior low-segment vertical cesarean incision

Article Abstract:

It appears that vaginal delivery can successfully be accomplished in most women who have previously had cesareans using a vertical incision. Results from 10 studies were pooled to compare success rates of subsequent vaginal deliveries and possible complications on a total of 372 women with previous cesareans performed with a vertical incision. Eighty-two percent of these women had uncomplicated subsequent vaginal deliveries. Four women had uterine tearing during a subsequent delivery. Two of these ruptures occurred at sites other than the initial incision. There were no further complications reported with these four deliveries.

Planning, Injuries, Vaginal birth after cesarean, Abdomen, Abdominal injuries

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Premature rupture of membranes at 34 to 37 weeks' gestation: aggressive versus conservative management

Article Abstract:

Inducing labor in women whose membranes rupture prematurely between 34 and 36 weeks of pregnancy appears to be safe. Researchers randomly assigned 120 women with premature rupture of membranes to observation only or to aggressive induction of labor with oxytocin. Infection of fetal membranes was more likely in the women under observation and their hospital stays were longer. Among the infants, birth weights and Apgar scores were similar. The rate of neonatal complications was also similar between the two groups.

Care and treatment, Evaluation, Premature rupture of membranes, Premature rupture of the membrane, Labor, Induced (Obstetrics), Induced labor

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