Warning symptoms, uterine contractions, and cervical examination findings in women at risk of preterm delivery

Article Abstract:

Delivering a fetus before the 36th week of pregnancy is fraught with many fetal complications and even death. Most premature deliveries result from early labor and premature rupture of the membranes surrounding the fetus. If therapy designed to control preterm labor is begun early, the chances for a preterm delivery are significantly decreased. The usefulness of recognizing the warning signs and symptoms of preterm labor has not been determined. The predictive value of each sign and symptom of preterm labor and the frequency with which they occur have been established for three different gestational ages: 21 to 25 weeks, 26 to 30 weeks and 31 to 35 weeks. The frequency of warning signs such as backache, cramping and pressure increased as the pregnancy progressed. The frequency of diarrhea, vaginal bleeding and vaginal discharge remained the same throughout pregnancy. The frequency of contractions and changes in the cervix increased with gestational age. Diarrhea and vaginal discharge were associated with a diagnosis of early labor. While some patterns of uterine contractions were associated with preterm labor and delivery, no one pattern was statistically significant, nor was one particular sign associated with spontaneous delivery. Changes in the characteristics of the cervix, such as thinning and dilatation, could be used to predict preterm delivery, but only after 25 weeks of gestation. Since identifying the signs and symptoms of early labor has little value in predicting premature labor and delivery, educating patients, which can be time consuming, is of little benefit. Cervical examinations, however, may prove useful in predicting women at risk for premature labor and delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Causes of, Risk factors, Premature labor, Pregnancy, Complications of, Pregnancy complications

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A multicenter study of preterm birth weight and gestational age-specific neonatal mortality

Article Abstract:

Survival of preterm, low birth weight infants continues to increase although this trend appears to be due to improved care and not to a drop in the incidence of preterm deliveries. Of 33,792 newborn infants, 3,386 had a gestational age of at least 20 weeks but not more than 37 weeks. Overall, there were 349 deaths among the newborn infants, and 83% of them occurred in infants born at less than 37 weeks and 66% of them were among infants born at less than 29 weeks. Gestational age was more important than birth weight in determining survival among infants delivered before 29 weeks. Between 29 and 36 weeks however, gestational age was less important than birth weight in predicting infant deaths. Before 29 weeks, male infants and twins had significantly higher infant death rates than females and singletons. Survival rates among preterm and low birth weight infants were higher among black than white infants, but overall the infant death rate was higher among black infants than white.

Infants (Newborn), Newborn infants, Premature birth, Birth weight, Gestational age

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Low-dose aspirin therapy to prevent preeclampsia

Article Abstract:

Treatment with a low dosage of aspirin each day may be an effective method for preventing or reducing the severity of preeclampsia in pregnant women. Preeclampsia is the development of hypertension during pregnancy with increased levels of protein in the urine and fluid collection. Among 604 pregnant women under 28 years old in the 24th week of pregnancy, 302 took 60 milligrams of aspirin per day and 302 took a placebo, or an inactive substance, until the time of delivery. Five women (2%) treated with aspirin developed preeclampsia, compared with 17 women (6%) who took a placebo. Only one women in the aspirin group developed severe preeclampsia, compared with six women in the placebo group. Preeclampsia and other pregnancy-associated hypertensive disorders cause a significant number of fetal, newborn and maternal deaths.

Prevention, Preeclampsia, Aspirin

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