Materiały źródłowe

• #1 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth – Preterm Birth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11373/

  The diagnosis and treatment of preterm labor is currently based on an inadequate literature. Not only is there a paucity of well-designed and adequately powered clinical trials, but there is incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor. To date, there is no single test or sequence of assessment measures to accurately predict preterm birth. […] The ultimate goal of treatment for preterm labor is to eliminate or reduce perinatal morbidity and mortality. Thus, despite several interventions designed to inhibit preterm labor and prolong pregnancy, the frequency of preterm birth continues to pose a major barrier to the health of newborns worldwide. […] The methods for the diagnosis and treatment of preterm labor are based on an inadequate literature that is compromised not only by the oft-cited paucity of well-designed and adequately powered clinical trials but also, even more, by an incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor, such as progressive cervical dilatation and ruptured membranes.

• #1 Preterm Labor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536939/

  Spontaneous preterm labor (sPTL) is characterized by cervical changes triggered by regular uterine contractions occurring between 20 0/7 and 36 6/7 weeks of gestational age (EGA). Diagnostic criteria vary, with the American College of Obstetricians and Gynecologists defining sPTL as cervical dilation of at least 2 cm before 37 weeks EGA, while international guidelines suggest a cutoff of 3 cm. Patients presenting with symptoms such as contractions, pelvic or back pain, vaginal bleeding, or fluid leakage undergo evaluations involving history, pelvic examination, and potentially transvaginal ultrasound or fetal fibronectin testing. […] The American College of Obstetricians and Gynecologists (ACOG) also states that PTL can be diagnosed in patients with regular contractions and cervical dilation of at least 2 cm before 37 weeks EGA, while the international guidelines from the World Association of Perinatal Medicine and the Perinatal Medicine Foundation (WAPM-PMF) recommend using a cutoff of at least 3 cm to diagnose spontaneous preterm labor (sPTL).

• #2 Preterm labor: Clinical findings, diagnostic evaluation, and initial treatment – UpToDate

  https://www.uptodate.com/contents/preterm-labor-clinical-findings-diagnostic-evaluation-and-initial-treatment

  Preterm labor: Clinical findings, diagnostic evaluation, and initial treatment […] Identifying patients with preterm contractions who will go on to give birth preterm is an inexact process, even though preterm labor is one of the most common reasons for hospitalization in pregnancy. Accurate identification of patients in true preterm labor allows appropriate application of interventions that can improve neonatal outcome: antenatal corticosteroid therapy, short-term tocolysis, antibiotic prophylaxis against early-onset neonatal group B streptococcal infection, magnesium sulfate for neuroprotection, and, if necessary, maternal transfer to a facility with an appropriate level of newborn care. Accurate identification of patients who are contracting but not in preterm labor is just as important as it avoids unnecessary and sometimes costly interventions in the approximately 50 percent of patients with suspected (also called threatened) preterm labor who subsequently give birth at term without tocolytic therapy. […] This topic will describe the clinical findings and diagnostic evaluation of patients who present with signs and symptoms of preterm labor, and initial management of those in whom a diagnosis of preterm labor is made.

• #2 Preterm Labor: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0515/p2457.html

  The clinical factors associated with preterm labor are listed in Table 1. […] Consequently, family physicians should identify all women in early preterm labor or at risk for preterm labor. […] Identification of the symptoms of preterm labor will help ensure that the patient can be evaluated, diagnosed and treated appropriately. The signs and symptoms that appear to predict preterm labor include frequent contractions (more than four per hour), cramping, pelvic pressure, excessive vaginal discharge, backache and low back pain. […] A diagnosis of preterm labor should be made in a patient between 20 weeks and 36 weeks, six days of gestation if uterine contractions occur at a frequency of four per 20 minutes or eight per 60 minutes, and are accompanied by one of the following: PROM, cervical dilation greater than 2 cm, effacement exceeding 50 percent, or a change in cervical dilation or effacement detected by serial examinations.

• #3 SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth | Preterm Birth: Causes, Consequences, and Prevention | The National Academies Press

  https://nap.nationalacademies.org/read/11622/chapter/13

  The diagnosis and treatment of preterm labor is currently based on an inadequate literature. Not only is there a paucity of well-designed and adequately powered clinical trials, but there is incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor. To date, there is no single test or sequence of assessment measures to accurately predict preterm birth. […] The ultimate goal of treatment for preterm labor is to eliminate or reduce perinatal morbidity and mortality. Thus, despite several interventions designed to inhibit preterm labor and prolong pregnancy, the frequency of preterm birth continues to pose a major barrier to the health of newborns worldwide. […] Although current obstetric and neonatal strategies have resulted in improved rates of neonatal survival and an earlier threshold for viability, effective strategies for the prevention of preterm birth are urgently needed.

• #3 Preterm Labor: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0515/p2457.html

  The clinical factors associated with preterm labor are listed in Table 1. […] Consequently, family physicians should identify all women in early preterm labor or at risk for preterm labor. […] Identification of the symptoms of preterm labor will help ensure that the patient can be evaluated, diagnosed and treated appropriately. The signs and symptoms that appear to predict preterm labor include frequent contractions (more than four per hour), cramping, pelvic pressure, excessive vaginal discharge, backache and low back pain. […] A diagnosis of preterm labor should be made in a patient between 20 weeks and 36 weeks, six days of gestation if uterine contractions occur at a frequency of four per 20 minutes or eight per 60 minutes, and are accompanied by one of the following: PROM, cervical dilation greater than 2 cm, effacement exceeding 50 percent, or a change in cervical dilation or effacement detected by serial examinations.

• #4 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Your healthcare professional reviews your medical history, your risk factors for preterm labor and your symptoms. If you have regular uterine contractions and your cervix starts to soften, thin and open, called dilate, before 37 weeks of pregnancy, you likely are in preterm labor. […] Tests and procedures to diagnose preterm labor include: […] A transvaginal ultrasound can measure the length of your cervix. An ultrasound also can show the fetus’s size and position. And it can check for issues with the fetus or placenta and show the volume of amniotic fluid. […] Your healthcare professional might take a swab of your vagina to check for certain infections and a substance called fibronectin. That substance acts like glue between the fetal sac and the lining of the uterus. It’s released during labor. Your healthcare professional reviews these results with other risk factors. A urine sample can show certain bacteria.

• #5 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Your healthcare professional reviews your medical history, your risk factors for preterm labor and your symptoms. If you have regular uterine contractions and your cervix starts to soften, thin and open, called dilate, before 37 weeks of pregnancy, you likely are in preterm labor. […] Tests and procedures to diagnose preterm labor include: […] A transvaginal ultrasound can measure the length of your cervix. An ultrasound also can show the fetus’s size and position. And it can check for issues with the fetus or placenta and show the volume of amniotic fluid. […] Your healthcare professional might take a swab of your vagina to check for certain infections and a substance called fibronectin. That substance acts like glue between the fetal sac and the lining of the uterus. It’s released during labor. Your healthcare professional reviews these results with other risk factors. A urine sample can show certain bacteria.

• #6 Preterm Birth: Premature, Causes, Symptoms & Complications

  https://my.clevelandclinic.org/health/diseases/21479-premature-birth

  Preterm infants often need specialized medical care in a NICU. This is a specific part of the hospital for babies that need extra care and medical attention. Some babies stay in the NICU for weeks or months. […] A premature baby doesnt have enough time to fully develop. This means certain organs and body systems may not be ready to support them in their life outside the uterus. This can cause serious health problems. Preemie babies often need special care in a NICU before they can leave the hospital. After a premature baby is born, a neonatologist evaluates them to determine what type of care they may need. […] Premature babies are also at a higher risk of developmental challenges during childhood. They may have health issues later in life, including: Cerebral palsy, Hearing and vision problems, Learning disabilities, Poor growth, Problems with communication or social development. […] Premature birth can create serious health concerns for a baby. When an infant doesnt have enough time to develop in the uterus, important organs may not develop fully. However, advances in newborn care are helping many preterm infants grow into healthy, robust children.

• #7 Preterm Labor: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0515/p2457.html

  The clinical factors associated with preterm labor are listed in Table 1. […] Consequently, family physicians should identify all women in early preterm labor or at risk for preterm labor. […] Identification of the symptoms of preterm labor will help ensure that the patient can be evaluated, diagnosed and treated appropriately. The signs and symptoms that appear to predict preterm labor include frequent contractions (more than four per hour), cramping, pelvic pressure, excessive vaginal discharge, backache and low back pain. […] A diagnosis of preterm labor should be made in a patient between 20 weeks and 36 weeks, six days of gestation if uterine contractions occur at a frequency of four per 20 minutes or eight per 60 minutes, and are accompanied by one of the following: PROM, cervical dilation greater than 2 cm, effacement exceeding 50 percent, or a change in cervical dilation or effacement detected by serial examinations.

• #8 Signs and symptoms of preterm labor | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/signs-and-symptoms-preterm-labor

  Preterm labor is labor that happens before 37 weeks of pregnancy. Babies born this early can have lifelong or life-threatening health problems. […] Learn the signs and symptoms of preterm labor. If you have even one sign or symptom, call your health care provider. […] If you have even one sign or symptom of preterm labor, call your health care provider right away. If you have preterm labor, getting help quickly is the best thing you can do. […] When you see your provider, they may do a pelvic exam or a transvaginal ultrasound to see if your cervix has started to become thinner and open for labor. […] If you’re having preterm labor, your provider may give you treatment to help stop it or to help improve your baby’s health before birth.

• #9 Premature Birth: Causes and Symptoms of Preterm Birth

  https://www.careinsurance.com/blog/health-insurance-articles/what-are-the-possible-causes-of-premature-birth

  It may also happen that women with a history of premature birth in a previous pregnancy may be at a higher risk of low birth weight and prematurity. Proper healthcare and medical attention can be helpful. […] Apart from the aforementioned, several other complications may also be reasons for premature labour, like weak cervix opening, abnormal uterus, unhealthy weight, etc. Also, early pregnancy, like those in 16-17 years of age or above 35 years of age, may be the causes of preterm labour. […] Preterm labour symptoms can be hard to distinguish from normal pregnancy symptoms. Therefore, it is important to get your possible symptoms checked out by your healthcare practitioner. Here are the signs and symptoms of preterm labour in women: Regular Contractions, Backpain, Vaginal Discharge, Pelvic Pressure, Ruptured Membranes, Cramps or Abdominal Pain, Gastrointestinal Symptoms.

• #10 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth – Preterm Birth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11373/

  Useful studies of methods for the prevention or arrest of preterm labor therefore depend on the development of more accurate methods for the diagnosis of preterm labor. […] The accurate diagnosis of early preterm labor is difficult because the symptoms and signs of preterm labor commonly occur in healthy women who do not deliver preterm and because digital examination of the cervix in early labor is not highly reproducible. […] Other means of enhancing diagnostic accuracy in preterm labor include transvaginal sonographic measurement of cervical length and testing for fetal fibronectin in cervicovaginal fluid. […] Despite evidence that the overdiagnosis of preterm labor in women with frequent contractions is common and results in unnecessary treatment, the clinical use of the fibronectin test and cervical sonography is not widespread.

• #11 Preterm Labor Diagnosis | NYU Langone Health

  https://nyulangone.org/conditions/preterm-labor/diagnosis

  Preterm labor happens when a womans body prepares for birth before the baby is considered full term, which is 37 weeks into the pregnancy. Doctors monitor for signs that labor may be taking place before the babys due date. […] Contact your doctor if you have symptoms of labor while pregnant; you may be advised to go to the doctors office or to the hospital. From there, your doctor can determine whether you are in labor. […] The symptoms of preterm labor dont always mean a baby is delivered prematurely. […] To confirm that preterm labor is taking place, your doctor conducts a pelvic exam to determine whether your cervix has begun to dilate, or open, to prepare for birth. […] If you are experiencing regular contractions before 34 of pregnancy, your doctor may swab the cervix and test the secretions for fetal fibronectin. […] If youre experiencing the symptoms of labor before week 37 of pregnancy, your doctor may ask for a urine sample in order to check for a bladder or urinary tract infection, which can lead to preterm contractions.

• #12 Preterm birth – Wikipedia

  https://en.wikipedia.org/wiki/Preterm_birth

  Fetal fibronectin (fFN) has become an important biomarker; the presence of this glycoprotein in the cervical or vaginal secretions indicates that the border between the chorion and decidua has been disrupted. […] Obstetric ultrasound has become useful in the assessment of the cervix in women at risk for premature delivery. A short cervix preterm is undesirable: A cervical length of less than 25 mm (0.98 in) at or before 24 weeks of gestational age is the most common definition of cervical incompetence. […] Technologies under research and development to facilitate earlier diagnosis of preterm births include sanitary pads that identify biomarkers such as fFN and PAMG-1 and others, when placed into the vagina.

• #13 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Your healthcare professional reviews your medical history, your risk factors for preterm labor and your symptoms. If you have regular uterine contractions and your cervix starts to soften, thin and open, called dilate, before 37 weeks of pregnancy, you likely are in preterm labor. […] Tests and procedures to diagnose preterm labor include: […] A transvaginal ultrasound can measure the length of your cervix. An ultrasound also can show the fetus’s size and position. And it can check for issues with the fetus or placenta and show the volume of amniotic fluid. […] Your healthcare professional might take a swab of your vagina to check for certain infections and a substance called fibronectin. That substance acts like glue between the fetal sac and the lining of the uterus. It’s released during labor. Your healthcare professional reviews these results with other risk factors. A urine sample can show certain bacteria.

• #14 Preterm Labor and Birth | ACOG

  https://www.acog.org/womens-health/faqs/preterm-labor-and-birth

  Preterm labor is labor that starts before 37 weeks of pregnancy. […] Preterm birth is the birth of a baby before 37 weeks. […] Preterm labor is diagnosed when changes in the cervix are found after contractions start. […] Your ob-gyn may do a pelvic exam to see if your cervix has started to change. […] There are several tests that may be ordered: An ultrasound exam to estimate gestational age or to check the size of your fetus. […] A transvaginal ultrasound exam to measure the length of the cervix. […] A vaginal swab to test for the presence of fetal fibronectin. […] If you have preterm labor, it is difficult for health care professionals to predict whether you will go on to have preterm birth. […] The goals of monitoring and treatment are to reduce the risk of preterm birth and protect the health of you and your fetus.

• #15 Preterm birth – Wikipedia

  https://en.wikipedia.org/wiki/Preterm_birth

  Fetal fibronectin (fFN) has become an important biomarker; the presence of this glycoprotein in the cervical or vaginal secretions indicates that the border between the chorion and decidua has been disrupted. […] Obstetric ultrasound has become useful in the assessment of the cervix in women at risk for premature delivery. A short cervix preterm is undesirable: A cervical length of less than 25 mm (0.98 in) at or before 24 weeks of gestational age is the most common definition of cervical incompetence. […] Technologies under research and development to facilitate earlier diagnosis of preterm births include sanitary pads that identify biomarkers such as fFN and PAMG-1 and others, when placed into the vagina.

• #16 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Your healthcare professional reviews your medical history, your risk factors for preterm labor and your symptoms. If you have regular uterine contractions and your cervix starts to soften, thin and open, called dilate, before 37 weeks of pregnancy, you likely are in preterm labor. […] Tests and procedures to diagnose preterm labor include: […] A transvaginal ultrasound can measure the length of your cervix. An ultrasound also can show the fetus’s size and position. And it can check for issues with the fetus or placenta and show the volume of amniotic fluid. […] Your healthcare professional might take a swab of your vagina to check for certain infections and a substance called fibronectin. That substance acts like glue between the fetal sac and the lining of the uterus. It’s released during labor. Your healthcare professional reviews these results with other risk factors. A urine sample can show certain bacteria.

• #17 Diagnosis and Management of Preterm Labor | Article | GLOWM

  https://www.glowm.com/article/heading/vol-11–labor-and-delivery–diagnosis-and-management-of-preterm-labor/id/412883

  A systematic review and meta-analysis found that screening using cervical length by transvaginal sonography is associated with a lower incidence of preterm birth in singleton pregnancies with threatened preterm labor. […] A Cochrane review found that testing for fibronectin can significantly decrease preterm birth rate, the control group had a preterm delivery of 28.6% and the fibronectin screened women who were managed accordingly, had a preterm delivery of 15.6%. […] If preterm labor is suspected after the clinical assessment, then the gestational age determines the management. […] Maternal corticosteroids are considered in preterm labor as they have been demonstrated to reduce the risk of respiratory distress syndrome and intraventricular hemorrhage. […] Tocolytics refer to medications intended to suppress contractions.

• #18 Preterm labor – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1002

  Key diagnostic factors include history of preterm labor, cervical trauma, or induced abortion, multifetal pregnancy and presence of maternal infection, uterine contractions, preterm prelabor rupture of membranes (PPROM), advanced cervical dilation, and cervical length 2 cm. […] Diagnostic tests include nonstress cardiotocogram, tocography, transvaginal ultrasound of the cervix, cervico-vaginal swab for fetal fibronectin, CBC, CRP, urine dipstick, urine microscopy, culture, and sensitivity, and high vaginal/rectal culture.

• #19 Preterm Labor – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/preterm-labor

  Diagnosis of preterm labor is based on signs of labor and length of the pregnancy. […] Anovaginal cultures for group B streptococci are done, and antibiotic prophylaxis is initiated (and then discontinued if cultures are negative). […] Many women with preterm contractions are not in labor, and some women diagnosed with preterm labor do not progress to delivery. […] Management of preterm labor includes antibiotics (if infection is diagnosed or suspected), tocolytics, and corticosteroids. […] If the cervix dilates, tocolytics (drugs that stop uterine contractions) can usually delay labor for at least 48 hours so that corticosteroids can be given to reduce risks to the fetus. […] If the fetus is 24 to 34 weeks, women are given corticosteroids unless delivery is imminent. […] Corticosteroids should also be considered in the following circumstances: Starting at 23 0/7 weeks gestation if there is a risk of preterm delivery within 7 days. […] An injectable progestin is no longer recommended for women with a history of preterm delivery to reduce the risk of recurrence.

• #20 Preterm Labor Diagnosis | NYU Langone Health

  https://nyulangone.org/conditions/preterm-labor/diagnosis

  Preterm labor happens when a womans body prepares for birth before the baby is considered full term, which is 37 weeks into the pregnancy. Doctors monitor for signs that labor may be taking place before the babys due date. […] Contact your doctor if you have symptoms of labor while pregnant; you may be advised to go to the doctors office or to the hospital. From there, your doctor can determine whether you are in labor. […] The symptoms of preterm labor dont always mean a baby is delivered prematurely. […] To confirm that preterm labor is taking place, your doctor conducts a pelvic exam to determine whether your cervix has begun to dilate, or open, to prepare for birth. […] If you are experiencing regular contractions before 34 of pregnancy, your doctor may swab the cervix and test the secretions for fetal fibronectin. […] If youre experiencing the symptoms of labor before week 37 of pregnancy, your doctor may ask for a urine sample in order to check for a bladder or urinary tract infection, which can lead to preterm contractions.

• #21 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Your healthcare professional reviews your medical history, your risk factors for preterm labor and your symptoms. If you have regular uterine contractions and your cervix starts to soften, thin and open, called dilate, before 37 weeks of pregnancy, you likely are in preterm labor. […] Tests and procedures to diagnose preterm labor include: […] A transvaginal ultrasound can measure the length of your cervix. An ultrasound also can show the fetus’s size and position. And it can check for issues with the fetus or placenta and show the volume of amniotic fluid. […] Your healthcare professional might take a swab of your vagina to check for certain infections and a substance called fibronectin. That substance acts like glue between the fetal sac and the lining of the uterus. It’s released during labor. Your healthcare professional reviews these results with other risk factors. A urine sample can show certain bacteria.

• #22 Preterm labor – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1002

  Key diagnostic factors include history of preterm labor, cervical trauma, or induced abortion, multifetal pregnancy and presence of maternal infection, uterine contractions, preterm prelabor rupture of membranes (PPROM), advanced cervical dilation, and cervical length 2 cm. […] Diagnostic tests include nonstress cardiotocogram, tocography, transvaginal ultrasound of the cervix, cervico-vaginal swab for fetal fibronectin, CBC, CRP, urine dipstick, urine microscopy, culture, and sensitivity, and high vaginal/rectal culture.

• #23 Diagnosis and Management of Preterm Labor | Article | GLOWM

  https://www.glowm.com/article/heading/vol-11–labor-and-delivery–diagnosis-and-management-of-preterm-labor/id/412883

  Magnesium sulfate has been shown to offer neuroprotection for the fetus, reducing fetal cerebral palsy and motor dysfunction. […] Intrauterine infection should be assessed by a combination of clinical assessment, maternal C-reactive protein (CRP) and white blood count, plus fetal heart rate. […] According to NICE and RCOG, antibiotics should be given following diagnosis of PPROM. […] Delivery at the threshold of viability refers to babies born at 23-24+6 weeks of gestation. […] Investigations after a preterm delivery are carried out to try to determine the cause, if possible.

• #24 Preterm birth – Wikipedia

  https://en.wikipedia.org/wiki/Preterm_birth

  Preterm birth may be prevented in those at risk if the hormone progesterone is taken during pregnancy. Evidence does not support the usefulness of bed rest to prevent preterm labor. […] In women who might deliver between 24 and 37 weeks, corticosteroid treatment may improve outcomes. […] Identifying women at high risk of giving birth early would enable the health services to provide specialized care for these women and their babies, for example a hospital with a special care baby unit such as a neonatal intensive care unit (NICU). […] The absence of prenatal care has been associated with higher rates of preterm births. […] Placental alpha microglobulin-1 (PAMG-1) has been the subject of several investigations evaluating its ability to predict imminent spontaneous preterm birth in women with signs, symptoms, or complaints suggestive of preterm labor.

• #25 Preterm labor – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1002

  Preterm labor can be caused by various factors and occurs between 24 and 37 weeks’ gestation. […] Early spontaneous birth can be predicted using serial digital examination or transvaginal ultrasound of the cervix. Fetal fibronectin detected in cervico-vaginal secretions can also be used. Combining cervical ultrasound and fetal fibronectin gives the best prediction of progression to preterm birth. […] There is no internationally recognized definition of preterm labor. Preterm birth occurs between 24 and 37 weeks’ gestation. […] Only a minority of women who present with preterm contractions known as threatened preterm labor (TPTL) progress to actual labor and delivery. […] Preterm prelabor rupture of membranes (PPROM) is defined as the rupture of membranes at 37 weeks’ gestation and prior to the onset of labor.

• #26 Preterm Labor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536939/

  The evaluation of patients with threatened PTL includes collecting samples to test patients for ruptured membranes, urogenital infections, and the presence of fetal fibronectin (fFN) in cervicovaginal secretions, as well as transvaginal and limited obstetric ultrasounds. […] Management of sPTL is based on the EGA at presentation, cervical dilation, membrane status, and, in some cases, cervical length with or without fFN. Patients with threatened PTL are considered at high risk of sPTB within the next 7 days if they meet at least 1 criteria of the following: Regular contractions and cervical dilation of 3 cm or more; Regular contractions with demonstrated cervical change over time; Symptoms of sPTL and a short cervical length (defined as less than 15 mm to 20 mm) regardless of fFN results; Symptoms of sPTL, an intermediate cervical length (defined as between 15 to 20 mm and 30 mm), and positive fFN; Ruptured membranes. […] Antenatal corticosteroids improve neonatal outcomes when given to individuals at high risk of PTB; these are most effective between 48 hours and 7 days before PTB.

• #27 Preterm Labor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536939/

  The evaluation of patients with threatened PTL includes collecting samples to test patients for ruptured membranes, urogenital infections, and the presence of fetal fibronectin (fFN) in cervicovaginal secretions, as well as transvaginal and limited obstetric ultrasounds. […] Management of sPTL is based on the EGA at presentation, cervical dilation, membrane status, and, in some cases, cervical length with or without fFN. Patients with threatened PTL are considered at high risk of sPTB within the next 7 days if they meet at least 1 criteria of the following: Regular contractions and cervical dilation of 3 cm or more; Regular contractions with demonstrated cervical change over time; Symptoms of sPTL and a short cervical length (defined as less than 15 mm to 20 mm) regardless of fFN results; Symptoms of sPTL, an intermediate cervical length (defined as between 15 to 20 mm and 30 mm), and positive fFN; Ruptured membranes. […] Antenatal corticosteroids improve neonatal outcomes when given to individuals at high risk of PTB; these are most effective between 48 hours and 7 days before PTB.

• #28 Prematurity: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/975909-overview

  Prematurity is a term for the broad category of neonates born at less than 37 weeks’ gestation. Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. For premature infants born with a weight below 1000 g, the three primary causes of mortality are respiratory failure, infection, and congenital malformation. […] Confirmation of gestational age is based on physical and neurologic characteristics. The Ballard Scoring System remains the main tool clinicians use after delivery to confirm gestational age by means of physical examination. […] Initial laboratory studies in cases of prematurity are performed to identify issues that, if corrected, improve the patient’s outcome. Such tests include the following: Frequent blood glucose measurement: This is essential because premature infants are prone to hypoglycemia and hyperglycemia.

• #29 Preterm Infants – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/preterm-infants

  An infant born before 37 weeks of gestation is considered preterm. […] A diagnosis of prematurity depends on the best estimate of gestational age. Neonatal gestational age is usually defined by counting the number of weeks between the first day of the mother’s last normal menstrual period and the date of delivery. […] Along with appropriate testing for any identified problems or disorders, routine evaluations include pulse oximetry, complete blood count, electrolytes, bilirubin level, blood culture, serum calcium, alkaline phosphatase, and phosphorus levels (to screen for osteopenia of prematurity), hearing evaluation, cranial ultrasound (to screen for intraventricular hemorrhage and periventricular leukomalacia), and screening by an ophthalmologist for retinopathy of prematurity (depending on gestational age). […] Screening for retinopathy of prematurity is recommended for infants born 1500 g or 30 weeks of gestational age and for larger and more mature infants who have had an unstable clinical course. The first examination is done according to a schedule based on the infant’s gestational age.

• #30 Preterm Birth: Premature, Causes, Symptoms & Complications

  https://my.clevelandclinic.org/health/diseases/21479-premature-birth

  Preterm infants often need specialized medical care in a NICU. This is a specific part of the hospital for babies that need extra care and medical attention. Some babies stay in the NICU for weeks or months. […] A premature baby doesnt have enough time to fully develop. This means certain organs and body systems may not be ready to support them in their life outside the uterus. This can cause serious health problems. Preemie babies often need special care in a NICU before they can leave the hospital. After a premature baby is born, a neonatologist evaluates them to determine what type of care they may need. […] Premature babies are also at a higher risk of developmental challenges during childhood. They may have health issues later in life, including: Cerebral palsy, Hearing and vision problems, Learning disabilities, Poor growth, Problems with communication or social development. […] Premature birth can create serious health concerns for a baby. When an infant doesnt have enough time to develop in the uterus, important organs may not develop fully. However, advances in newborn care are helping many preterm infants grow into healthy, robust children.

• #31 Premature birth – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc-20376736

  A premature baby in the NICU may need to have many tests. Some tests are ongoing. Other exams may be done only if the NICU staff thinks the baby might have a certain health problem. […] Tests your premature baby may need include: […] Blood tests. Blood samples are taken by pricking the heel or placing a needle in a vein. These tests let the NICU staff closely watch the levels of important substances in your baby’s blood, such as calcium and blood sugar. A blood sample also may be checked to look for signs of problems such as anemia or illnesses. […] Echocardiography. This imaging test is an ultrasound of the heart. It checks for problems with the way the heart works. It uses sound waves to make moving images on a display screen. […] Ultrasound. This imaging test may be done to check the brain for bleeding or fluid buildup. Or it can be used to check the organs in the stomach area for problems with the digestive tract, liver or kidneys. […] More tests may be needed if your baby has other health problems.

• #32 Bibliographies: 'Premature birth/diagnosis’ – Grafiati

  https://www.grafiati.com/en/literature-selections/premature-birth-diagnosis

  Full text Abstract: Background Diagnosis and treatment of patent ductus arteriosus (PDA) in premature infants is still an important problem for clinicians. […] Kindler, Annemarie, Barbara Seipolt, Antje Heilmann, Ursula Range, Mario Rdiger, and Sigrun Ruth Hofmann. „Development of a Diagnostic Clinical Score for Hemodynamically Significant Patent Ductus Arteriosus.” Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2018. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-232254. […] Full text Abstract: There is no consensus about the hemodynamic significance and, therefore, the need to treat a persistent ductus arteriosus in preterm newborns. […] false

• #33 Premature birth – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc-20376736

  A premature baby in the NICU may need to have many tests. Some tests are ongoing. Other exams may be done only if the NICU staff thinks the baby might have a certain health problem. […] Tests your premature baby may need include: […] Blood tests. Blood samples are taken by pricking the heel or placing a needle in a vein. These tests let the NICU staff closely watch the levels of important substances in your baby’s blood, such as calcium and blood sugar. A blood sample also may be checked to look for signs of problems such as anemia or illnesses. […] Echocardiography. This imaging test is an ultrasound of the heart. It checks for problems with the way the heart works. It uses sound waves to make moving images on a display screen. […] Ultrasound. This imaging test may be done to check the brain for bleeding or fluid buildup. Or it can be used to check the organs in the stomach area for problems with the digestive tract, liver or kidneys. […] More tests may be needed if your baby has other health problems.

• #34 Prematurity: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/975909-overview

  Prematurity is a term for the broad category of neonates born at less than 37 weeks’ gestation. Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. For premature infants born with a weight below 1000 g, the three primary causes of mortality are respiratory failure, infection, and congenital malformation. […] Confirmation of gestational age is based on physical and neurologic characteristics. The Ballard Scoring System remains the main tool clinicians use after delivery to confirm gestational age by means of physical examination. […] Initial laboratory studies in cases of prematurity are performed to identify issues that, if corrected, improve the patient’s outcome. Such tests include the following: Frequent blood glucose measurement: This is essential because premature infants are prone to hypoglycemia and hyperglycemia.

• #35 Premature birth – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc-20376736

  A premature baby in the NICU may need to have many tests. Some tests are ongoing. Other exams may be done only if the NICU staff thinks the baby might have a certain health problem. […] Tests your premature baby may need include: […] Blood tests. Blood samples are taken by pricking the heel or placing a needle in a vein. These tests let the NICU staff closely watch the levels of important substances in your baby’s blood, such as calcium and blood sugar. A blood sample also may be checked to look for signs of problems such as anemia or illnesses. […] Echocardiography. This imaging test is an ultrasound of the heart. It checks for problems with the way the heart works. It uses sound waves to make moving images on a display screen. […] Ultrasound. This imaging test may be done to check the brain for bleeding or fluid buildup. Or it can be used to check the organs in the stomach area for problems with the digestive tract, liver or kidneys. […] More tests may be needed if your baby has other health problems.

• #36 Premature birth – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/premature-birth/diagnosis-treatment/drc-20376736

  A premature baby in the NICU may need to have many tests. Some tests are ongoing. Other exams may be done only if the NICU staff thinks the baby might have a certain health problem. […] Tests your premature baby may need include: […] Blood tests. Blood samples are taken by pricking the heel or placing a needle in a vein. These tests let the NICU staff closely watch the levels of important substances in your baby’s blood, such as calcium and blood sugar. A blood sample also may be checked to look for signs of problems such as anemia or illnesses. […] Echocardiography. This imaging test is an ultrasound of the heart. It checks for problems with the way the heart works. It uses sound waves to make moving images on a display screen. […] Ultrasound. This imaging test may be done to check the brain for bleeding or fluid buildup. Or it can be used to check the organs in the stomach area for problems with the digestive tract, liver or kidneys. […] More tests may be needed if your baby has other health problems.

• #37 Prematurity: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/975909-overview

  Imaging studies are specific to the organ system affected. Chest radiography is performed to assess the lung parenchyma and heart size in newborns with respiratory distress. Cranial ultrasonography is performed to detect occult intracranial hemorrhage in premature infants. […] Lumbar puncture is performed in premature infants with positive blood cultures and in those who have clinical signs of central nervous system infection. […] Stabilization in the delivery room with prompt respiratory and thermal management is crucial to the immediate and long-term outcome of premature infants, particularly extremely premature infants. […] The three primary causes of mortality in infants born with a weight of less than 1000 g are respiratory failure, infection, and congenital malformation. Infection of the amniotic fluid leading to pneumonia is the major cause of mortality. […] Preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths, as well as 25-50% of cases of long-term neurologic impairment in children. Preterm delivery accounts for 75-80% of all neonatal morbidity and mortality.

• #38 Bibliographies: 'Premature birth/diagnosis’ – Grafiati

  https://www.grafiati.com/en/literature-selections/premature-birth-diagnosis

  Said, Aboayesh, and Dimitrie Nanu. „Diagnosis and treatment in premature births.” Romanian Medical Journal 62, no. 3 (September 30, 2015): 298302. http://dx.doi.org/10.37897/rmj.2015.3.17. […] Full text Abstract: Definition. Preterm birth means that birth occurs between 20 and 37 weeks of amenorrhea complete. (ACOG July 2014) In Romania, the declaration of pregnancy is made starting with 24 weeks of gestation. Outstanding progresses in the recovery of newborns weighing less than 1,000 grams (the US and Japan recovered newborns weighing 500 g and less) allowed international forums reconsider criteria for definition of prematurity (see abortion classifications). For performant neonatal departments, the presence of signs of life (beating heart, pulsation of the umbilical cord, muscle contracture to external stimuli) are sufficient to use resuscitation and recovering the product of conception.

• #39 Preterm Infants – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/preterm-infants

  An infant born before 37 weeks of gestation is considered preterm. […] A diagnosis of prematurity depends on the best estimate of gestational age. Neonatal gestational age is usually defined by counting the number of weeks between the first day of the mother’s last normal menstrual period and the date of delivery. […] Along with appropriate testing for any identified problems or disorders, routine evaluations include pulse oximetry, complete blood count, electrolytes, bilirubin level, blood culture, serum calcium, alkaline phosphatase, and phosphorus levels (to screen for osteopenia of prematurity), hearing evaluation, cranial ultrasound (to screen for intraventricular hemorrhage and periventricular leukomalacia), and screening by an ophthalmologist for retinopathy of prematurity (depending on gestational age). […] Screening for retinopathy of prematurity is recommended for infants born 1500 g or 30 weeks of gestational age and for larger and more mature infants who have had an unstable clinical course. The first examination is done according to a schedule based on the infant’s gestational age.

• #40 Preterm Infants – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/preterm-infants

  An infant born before 37 weeks of gestation is considered preterm. […] A diagnosis of prematurity depends on the best estimate of gestational age. Neonatal gestational age is usually defined by counting the number of weeks between the first day of the mother’s last normal menstrual period and the date of delivery. […] Along with appropriate testing for any identified problems or disorders, routine evaluations include pulse oximetry, complete blood count, electrolytes, bilirubin level, blood culture, serum calcium, alkaline phosphatase, and phosphorus levels (to screen for osteopenia of prematurity), hearing evaluation, cranial ultrasound (to screen for intraventricular hemorrhage and periventricular leukomalacia), and screening by an ophthalmologist for retinopathy of prematurity (depending on gestational age). […] Screening for retinopathy of prematurity is recommended for infants born 1500 g or 30 weeks of gestational age and for larger and more mature infants who have had an unstable clinical course. The first examination is done according to a schedule based on the infant’s gestational age.

• #41 Prematurity: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/975909-overview

  Imaging studies are specific to the organ system affected. Chest radiography is performed to assess the lung parenchyma and heart size in newborns with respiratory distress. Cranial ultrasonography is performed to detect occult intracranial hemorrhage in premature infants. […] Lumbar puncture is performed in premature infants with positive blood cultures and in those who have clinical signs of central nervous system infection. […] Stabilization in the delivery room with prompt respiratory and thermal management is crucial to the immediate and long-term outcome of premature infants, particularly extremely premature infants. […] The three primary causes of mortality in infants born with a weight of less than 1000 g are respiratory failure, infection, and congenital malformation. Infection of the amniotic fluid leading to pneumonia is the major cause of mortality. […] Preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths, as well as 25-50% of cases of long-term neurologic impairment in children. Preterm delivery accounts for 75-80% of all neonatal morbidity and mortality.

• #42 Preterm Infants – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/perinatal-problems/preterm-infants

  An infant born before 37 weeks of gestation is considered preterm. […] A diagnosis of prematurity depends on the best estimate of gestational age. Neonatal gestational age is usually defined by counting the number of weeks between the first day of the mother’s last normal menstrual period and the date of delivery. […] Along with appropriate testing for any identified problems or disorders, routine evaluations include pulse oximetry, complete blood count, electrolytes, bilirubin level, blood culture, serum calcium, alkaline phosphatase, and phosphorus levels (to screen for osteopenia of prematurity), hearing evaluation, cranial ultrasound (to screen for intraventricular hemorrhage and periventricular leukomalacia), and screening by an ophthalmologist for retinopathy of prematurity (depending on gestational age). […] Screening for retinopathy of prematurity is recommended for infants born 1500 g or 30 weeks of gestational age and for larger and more mature infants who have had an unstable clinical course. The first examination is done according to a schedule based on the infant’s gestational age.

• #43 Preterm Birth: Premature, Causes, Symptoms & Complications

  https://my.clevelandclinic.org/health/diseases/21479-premature-birth

  Preterm infants often need specialized medical care in a NICU. This is a specific part of the hospital for babies that need extra care and medical attention. Some babies stay in the NICU for weeks or months. […] A premature baby doesnt have enough time to fully develop. This means certain organs and body systems may not be ready to support them in their life outside the uterus. This can cause serious health problems. Preemie babies often need special care in a NICU before they can leave the hospital. After a premature baby is born, a neonatologist evaluates them to determine what type of care they may need. […] Premature babies are also at a higher risk of developmental challenges during childhood. They may have health issues later in life, including: Cerebral palsy, Hearing and vision problems, Learning disabilities, Poor growth, Problems with communication or social development. […] Premature birth can create serious health concerns for a baby. When an infant doesnt have enough time to develop in the uterus, important organs may not develop fully. However, advances in newborn care are helping many preterm infants grow into healthy, robust children.

• #44 Long-term consequences of prematurity | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/87/12/759

  Due to a shortened period of in utero organ development, premature infants are at higher risk of chronic respiratory, cardiac, renal, and endocrine system disorders later in life. […] With more premature babies being born and more of them surviving, internists and primary care practitioners should be aware of their patients birth history and of the potential long-term effects of prematurity. […] Such understanding can lead to early detection of disease and targeted lifestyle modifications. […] Survivors of premature birth may have later adverse health effects related to organs failing to achieve optimal development. […] Increased risk of cardiovascular, metabolic, and kidney diseases suggest that risk factors should be monitored and patients counseled on maintaining a healthy lifestyle.

• #45 Long-term health effects of preterm birth | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/long-term-health-effects-preterm-birth

  Preterm birth is birth that happens too soon, before 37 weeks of pregnancy. […] Babies born preterm may have more health problems at birth and later in life than babies born later. […] Preterm babies can have long-term intellectual and developmental disabilities and problems with their lungs, brain, eyes and other organs. […] Finding and treating health problems as early as possible can help preterm babies lead healthier lives. […] Preterm birth can lead to long-term intellectual and developmental disabilities for babies. […] Preterm birth can cause a baby to have lung and breathing problems, including: […] Preterm birth can lead to these health problems: […] Children born preterm are more likely to have hearing loss than children born on time. […] Preterm babies often have trouble fighting off germs because their immune systems are not fully developed. […] Vision problems, like retinopathy of prematurity (also called ROP). This is an eye disease that affects many premature babies.

• #46 Signs and symptoms of preterm labor | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/signs-and-symptoms-preterm-labor

  Preterm labor is labor that happens before 37 weeks of pregnancy. Babies born this early can have lifelong or life-threatening health problems. […] Learn the signs and symptoms of preterm labor. If you have even one sign or symptom, call your health care provider. […] If you have even one sign or symptom of preterm labor, call your health care provider right away. If you have preterm labor, getting help quickly is the best thing you can do. […] When you see your provider, they may do a pelvic exam or a transvaginal ultrasound to see if your cervix has started to become thinner and open for labor. […] If you’re having preterm labor, your provider may give you treatment to help stop it or to help improve your baby’s health before birth.

• #47 Prematurity | Phoenix Children’s Hospital

  https://phoenixchildrens.org/specialties-conditions/prematurity

  Premature babies can have long-term health problems as well. Generally, the more premature the baby, the more serious and long-lasting the health problems may be. […] It’s important to get good prenatal care while you are pregnant. […] Your healthcare provider may give you the hormone progesterone if you are at high risk for preterm birth. […] Before discharge, premature babies need an eye exam and hearing test to check for problems linked to prematurity. […] Premature babies are at increased risk for SIDS (sudden infant death syndrome).

• #48 preterm birth Diagnostics News | 360DxRSS FeedsVisit 360Dx on TwitterVisit 360Dx on LinkedIn

  https://www.360dx.com/disease-areas/preterm-birth

  In addition to its PreTRM test for predicting the risk of preterm delivery, the company aims to launch a DTC test for predicting due dates in late 2024 or early 2025. […] The company said the study met its two primary outcomes of reducing severe neonatal morbidity or neonatal death and decreasing the length of neonatal hospital stays. […] The South San Francisco-based startup recently published two studies showing the performance of its tests for predicting preterm birth and preeclampsia. […] Sera Publishes Data Showing PreTRM Test Can Predict Delivery Prior to 32 Weeks. […] Researchers Developing Biomarker Test for Potentially Fatal GI Tract Infection in Preterm Babies. […] International Team Developing Multimarker POC Test for Preterm Birth Risk. […] Preterm Birth Risk, Preeclampsia Exosome Tests Enter Clinical Validation. […] UCSF, Iowa Team Develops Proteomic Test for Preterm Birth. […] FDA Approves Qiagen’s Preterm Birth Risk Test. […] Sera Prognostics Gets NY State Approval to Test for Preterm Birth.

• #49 Frontiers | Assessment of current biomarkers and interventions to identify and treat women at risk of preterm birth

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1414428/full

  Preterm birth remains an important global problem, and an important contributor to under-5 mortality. Reducing spontaneous preterm birth rates at the global level will require the early identification of patients at risk of preterm delivery in order to allow the initiation of appropriate prophylactic management strategies. […] Unfortunately, current screening and diagnostic tests are non-specific, with only moderate clinical risk prediction, relying on the detection of downstream markers of the common end-stage pathway rather than identifying upstream pathway-specific pathophysiology that would help the provider initiate targeted interventions. […] Clearly defining preterm birth phenotypes and the biologic pathways leading to preterm birth is key to providing targeted, biomolecular pathway-specific interventions, ideally initiated in early pregnancy.

• #50 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  Preterm birth (PTB) is the primary cause of neonatal mortality and long-term disabilities. The unknown mechanism behind PTB makes diagnosis difficult, yet early detection is necessary for controlling and averting related consequences. The primary focus of this work is to provide an overview of the known risk factors associated with preterm labor and the conventional and advanced procedures for early detection of PTB, including multi-omics and artificial intelligence/machine learning (AI/ML)- based approaches. […] PTL can be diagnosed by analyzing cervical parameters, amniotic fluid, and different biomarkers. […] The conventional techniques involve physical and chemical testing. In contrast, the advanced techniques include multi-omics approaches for detecting biomarkers using a lateral flow or microfluidic device and AI/ML-based approaches for PTL/PTB risk prediction.

• #51 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  PTB/PTL risks can be predicted early using conventional and advanced procedures. […] The earlier reviews mainly concentrated on establishing a relationship between PTB and adult mortality, the impact of high temperatures during pregnancy, other risk variables, and inflammation. However, no one has systematically reviewed the guiding principles and evolving technologies for the early detection of PTB and associated POCT devices available in the market. […] Following an overview of PTB and its current global status, the present review addresses the early diagnosis of PTB using traditional and advanced techniques. […] The current methods for predicting PTB are mainly based on hypothesis-based identification of the risks under a controlled set-up, which may include age at pregnancy, multiple gestations, smoking, drugs or alcohol consumption, infections, and chronic illnesses.

• #52 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  AI/ML utilizes the electronic health record (EHR) or pre-defined clinical risk factors for better predictive performance. […] The point-of-care testing (POCT) devices must be “ASSURED” (affordable, sensitive, specific, user friendly, rapid, robust, equipment free, and delivered). […] The market size for PTB diagnostic test kits is predicted to grow from an estimated USD 419 million in 2022 to USD 857 million by 2032. […] The early prediction of the PTB is the major challenge that can help to reduce miscarriage cases and the associated PTB complications later in life for premature babies. […] The usage of diagnostic markers has several drawbacks, one of which is the potential for false negative diagnoses, which can increase the fetus’s risk of morbidity and death. […] The PTB rate was significantly reduced by 45% before 33 weeks of gestation for women with short cervical lengths who applied vaginal progesterone gel. […] The individual with an identified PTB risk should be admitted to a hospital, if necessary, and treated with tocolytics for delaying PTL, corticosteroids for avoiding perinatal complications, or hormonal supplements for maintaining pregnancy.

• #53 Ultrasounds can help predict the risk of preterm births, new research shows  | UIC today

  https://today.uic.edu/quantitative-ultrasound-preterm-birth/

  Researchers have developed a way to use ultrasound to predict whether a pregnant person is at risk of delivering a baby prematurely, which occurs in upward of 10% of pregnancies in the U.S. […] The current method for assessing a womans risk of preterm birth is based solely on whether she has previously given birth prematurely. This means there has been no way to assess risk in a first-time pregnancy. […] Our technique would be helpful in making decisions based on the tissue and not just on symptoms. […] In a study of 429 women who gave birth without induction at the University of Illinois Hospital, the new method was effective at predicting the risk of preterm births during first-time pregnancies. […] Together, over the past 22 years, they established that quantitative ultrasound could detect changes in the cervix and, as McFarlin had suspected long ago, that those changes help predict the risk of preterm delivery.

• #54 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  AI/ML utilizes the electronic health record (EHR) or pre-defined clinical risk factors for better predictive performance. […] The point-of-care testing (POCT) devices must be “ASSURED” (affordable, sensitive, specific, user friendly, rapid, robust, equipment free, and delivered). […] The market size for PTB diagnostic test kits is predicted to grow from an estimated USD 419 million in 2022 to USD 857 million by 2032. […] The early prediction of the PTB is the major challenge that can help to reduce miscarriage cases and the associated PTB complications later in life for premature babies. […] The usage of diagnostic markers has several drawbacks, one of which is the potential for false negative diagnoses, which can increase the fetus’s risk of morbidity and death. […] The PTB rate was significantly reduced by 45% before 33 weeks of gestation for women with short cervical lengths who applied vaginal progesterone gel. […] The individual with an identified PTB risk should be admitted to a hospital, if necessary, and treated with tocolytics for delaying PTL, corticosteroids for avoiding perinatal complications, or hormonal supplements for maintaining pregnancy.

• #55 PreTRM® Premature Birth Risk Blood Test from Sera

  https://www.pretrm.com/

  1 in 10 babies are born too soon. […] The PreTRM Test is the first of its kind for premature birth. […] The PreTRM Test is the only clinically validated commercially available blood test that provides an early, individual risk assessment for spontaneous preterm birth in asymptomatic, singleton pregnancies. […] Working together we can address problems of preterm birth. […] Understanding if your pregnancy is at higher risk for spontaneous preterm birth allows you and your physician to adjust your treatment plans accordingly. […] The PreTRM Test is a new tool providers and their patients can use to identify and address those at higher risk to improve outcomes. […] The AVERT PRETERM Trial demonstrated a significant reduction in the time the baby spent in the hospital and an 18% reduction in severe neonatal morbidity and mortality when higher-risk pregnancies identified by the PreTRM Test received risk-reduction interventions compared to standard care.

• #56 First Of Its Kind Blood Test Accurately Predicts Preterm Birth Risk – molecular-diagnostics – Labmedica.com

  https://www.labmedica.com/molecular-diagnostics/articles/294803757/first-of-its-kind-blood-test-accurately-predicts-preterm-birth-risk.html

  Preterm birth is one of the leading causes of childhood mortality worldwide. […] Now, a groundbreaking blood test has been developed that may predict the risk of preterm birth early in pregnancy. […] Initial tests of the blood test show promising potential, with the ability to predict the risk of preterm birth with accuracy as high as 97.5%. […] The researchers suggest that the test could be incorporated into the „prenatal battery,” a set of screenings designed to help clinicians identify factors that may increase a patient’s risk of preterm birth, allowing for early interventions before any symptoms appear. […] They are also exploring treatments that could „reset” the immune systems responses to normal levels to further reduce the risk of preterm birth.

• #57 Ultrasounds can help predict the risk of preterm births, new research shows  | UIC today

  https://today.uic.edu/quantitative-ultrasound-preterm-birth/

  Researchers have developed a way to use ultrasound to predict whether a pregnant person is at risk of delivering a baby prematurely, which occurs in upward of 10% of pregnancies in the U.S. […] The current method for assessing a womans risk of preterm birth is based solely on whether she has previously given birth prematurely. This means there has been no way to assess risk in a first-time pregnancy. […] Our technique would be helpful in making decisions based on the tissue and not just on symptoms. […] In a study of 429 women who gave birth without induction at the University of Illinois Hospital, the new method was effective at predicting the risk of preterm births during first-time pregnancies. […] Together, over the past 22 years, they established that quantitative ultrasound could detect changes in the cervix and, as McFarlin had suspected long ago, that those changes help predict the risk of preterm delivery.

• #58 Ultrasounds can help predict the risk of preterm births, new research shows  | UIC today

  https://today.uic.edu/quantitative-ultrasound-preterm-birth/

  If a clinician could know at 23 weeks that there was a risk of preterm birth, they would likely conduct extra appointments to keep an eye on the fetus, the researchers said. […] This study, OBrien explains, will allow other researchers to start studying processes by which you might be able to prevent or delay preterm birth.

• #59 Preterm Labor: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0515/p2457.html

  The literature clearly supports the efficacy of parenteral tocolytic agents in delaying delivery for 24 to 48 hours. […] Corticosteroid therapy is presently the only treatment shown to improve fetal survival when given to a woman in preterm labor between 24 and 34 weeks of gestation. […] Tocolytic therapy should be used to delay delivery in order to administer corticosteroids. At present, corticosteroid therapy is the only treatment shown to improve fetal survival and outcome.

• #60

  https://journals.lww.com/greenjournal/fulltext/2016/10000/practice_bulletin_no__171__management_of_preterm.61.aspx

  Identifying women with preterm labor who ultimately will give birth preterm is difficult. Approximately 30% of preterm labor spontaneously resolves and 50% of patients hospitalized for preterm labor actually give birth at term. Interventions to reduce the likelihood of delivery should be reserved for women with preterm labor at a gestational age at which a delay in delivery will provide benefit to the newborn. Because tocolytic therapy generally is effective for up to 48 hours, only women with fetuses that would benefit from a 48-hour delay in delivery should receive tocolytic treatment. […] The most beneficial intervention for improvement of neonatal outcomes among patients who give birth preterm is the administration of antenatal corticosteroids. A single course of corticosteroids is recommended for pregnant women between 24 weeks and 34 weeks of gestation who are at risk of delivery within 7 days. A Cochrane meta-analysis of corticosteroids therapy before 34 weeks of gestation reinforces the beneficial effect of this therapy regardless of membrane status and concludes that a single course of antenatal corticosteroids should be considered routine for all preterm deliveries. The administration of antenatal corticosteroids to the woman who is at risk of imminent preterm birth is strongly associated with decreased neonatal morbidity and mortality.

• #61 Preterm Labor – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/antenatal-complications/preterm-labor

  Diagnosis of preterm labor is based on signs of labor and length of the pregnancy. […] Anovaginal cultures for group B streptococci are done, and antibiotic prophylaxis is initiated (and then discontinued if cultures are negative). […] Many women with preterm contractions are not in labor, and some women diagnosed with preterm labor do not progress to delivery. […] Management of preterm labor includes antibiotics (if infection is diagnosed or suspected), tocolytics, and corticosteroids. […] If the cervix dilates, tocolytics (drugs that stop uterine contractions) can usually delay labor for at least 48 hours so that corticosteroids can be given to reduce risks to the fetus. […] If the fetus is 24 to 34 weeks, women are given corticosteroids unless delivery is imminent. […] Corticosteroids should also be considered in the following circumstances: Starting at 23 0/7 weeks gestation if there is a risk of preterm delivery within 7 days. […] An injectable progestin is no longer recommended for women with a history of preterm delivery to reduce the risk of recurrence.

• #62 Preterm Labor: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/1998/0515/p2457.html

  The literature clearly supports the efficacy of parenteral tocolytic agents in delaying delivery for 24 to 48 hours. […] Corticosteroid therapy is presently the only treatment shown to improve fetal survival when given to a woman in preterm labor between 24 and 34 weeks of gestation. […] Tocolytic therapy should be used to delay delivery in order to administer corticosteroids. At present, corticosteroid therapy is the only treatment shown to improve fetal survival and outcome.

• #63

  https://journals.lww.com/greenjournal/fulltext/2016/10000/practice_bulletin_no__171__management_of_preterm.61.aspx

  Identifying women with preterm labor who ultimately will give birth preterm is difficult. Approximately 30% of preterm labor spontaneously resolves and 50% of patients hospitalized for preterm labor actually give birth at term. Interventions to reduce the likelihood of delivery should be reserved for women with preterm labor at a gestational age at which a delay in delivery will provide benefit to the newborn. Because tocolytic therapy generally is effective for up to 48 hours, only women with fetuses that would benefit from a 48-hour delay in delivery should receive tocolytic treatment. […] The most beneficial intervention for improvement of neonatal outcomes among patients who give birth preterm is the administration of antenatal corticosteroids. A single course of corticosteroids is recommended for pregnant women between 24 weeks and 34 weeks of gestation who are at risk of delivery within 7 days. A Cochrane meta-analysis of corticosteroids therapy before 34 weeks of gestation reinforces the beneficial effect of this therapy regardless of membrane status and concludes that a single course of antenatal corticosteroids should be considered routine for all preterm deliveries. The administration of antenatal corticosteroids to the woman who is at risk of imminent preterm birth is strongly associated with decreased neonatal morbidity and mortality.

• #64 Diagnosis and Management of Preterm Labor | Article | GLOWM

  https://www.glowm.com/article/heading/vol-11–labor-and-delivery–diagnosis-and-management-of-preterm-labor/id/412883

  A systematic review and meta-analysis found that screening using cervical length by transvaginal sonography is associated with a lower incidence of preterm birth in singleton pregnancies with threatened preterm labor. […] A Cochrane review found that testing for fibronectin can significantly decrease preterm birth rate, the control group had a preterm delivery of 28.6% and the fibronectin screened women who were managed accordingly, had a preterm delivery of 15.6%. […] If preterm labor is suspected after the clinical assessment, then the gestational age determines the management. […] Maternal corticosteroids are considered in preterm labor as they have been demonstrated to reduce the risk of respiratory distress syndrome and intraventricular hemorrhage. […] Tocolytics refer to medications intended to suppress contractions.

• #65 Diagnosis and Management of Preterm Labor | Article | GLOWM

  https://www.glowm.com/article/heading/vol-11–labor-and-delivery–diagnosis-and-management-of-preterm-labor/id/412883

  Magnesium sulfate has been shown to offer neuroprotection for the fetus, reducing fetal cerebral palsy and motor dysfunction. […] Intrauterine infection should be assessed by a combination of clinical assessment, maternal C-reactive protein (CRP) and white blood count, plus fetal heart rate. […] According to NICE and RCOG, antibiotics should be given following diagnosis of PPROM. […] Delivery at the threshold of viability refers to babies born at 23-24+6 weeks of gestation. […] Investigations after a preterm delivery are carried out to try to determine the cause, if possible.

• #66 Preterm Labor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK536939/

  The evaluation of patients with threatened PTL includes collecting samples to test patients for ruptured membranes, urogenital infections, and the presence of fetal fibronectin (fFN) in cervicovaginal secretions, as well as transvaginal and limited obstetric ultrasounds. […] Management of sPTL is based on the EGA at presentation, cervical dilation, membrane status, and, in some cases, cervical length with or without fFN. Patients with threatened PTL are considered at high risk of sPTB within the next 7 days if they meet at least 1 criteria of the following: Regular contractions and cervical dilation of 3 cm or more; Regular contractions with demonstrated cervical change over time; Symptoms of sPTL and a short cervical length (defined as less than 15 mm to 20 mm) regardless of fFN results; Symptoms of sPTL, an intermediate cervical length (defined as between 15 to 20 mm and 30 mm), and positive fFN; Ruptured membranes. […] Antenatal corticosteroids improve neonatal outcomes when given to individuals at high risk of PTB; these are most effective between 48 hours and 7 days before PTB.

• #67 Diagnosis and Management of Preterm Labor | Article | GLOWM

  https://www.glowm.com/article/heading/vol-11–labor-and-delivery–diagnosis-and-management-of-preterm-labor/id/412883

  Magnesium sulfate has been shown to offer neuroprotection for the fetus, reducing fetal cerebral palsy and motor dysfunction. […] Intrauterine infection should be assessed by a combination of clinical assessment, maternal C-reactive protein (CRP) and white blood count, plus fetal heart rate. […] According to NICE and RCOG, antibiotics should be given following diagnosis of PPROM. […] Delivery at the threshold of viability refers to babies born at 23-24+6 weeks of gestation. […] Investigations after a preterm delivery are carried out to try to determine the cause, if possible.

• #68

  https://journals.lww.com/greenjournal/fulltext/2016/10000/practice_bulletin_no__171__management_of_preterm.61.aspx

  Intrauterine bacterial infection is an important cause of preterm labor, particularly at gestational ages less than 32 weeks. However, most trials have failed to demonstrate antibiotic benefit; a meta-analysis of eight randomized controlled trials that compared antibiotic treatment with placebo for patients with documented preterm labor found no difference between the antibiotic treatment and placebo for prolonging pregnancy or preventing preterm delivery, respiratory distress syndrome, or neonatal sepsis. Thus, antibiotics should not be used to prolong gestation or improve neonatal outcomes in women with preterm labor and intact membranes. […] The assessment of preterm delivery risk based on symptoms and physical examination alone is inaccurate. Prophylactic therapy (tocolytic drugs, bed rest, hydration, and sedation) in asymptomatic women at increased risk of preterm delivery has not been demonstrated to be effective. Although bed rest and hydration have been recommended to women with symptoms of preterm labor to prevent preterm delivery, these measures have not been shown to be effective for the prevention of preterm birth and should not be routinely recommended.

• #69 Preterm birth – Wikipedia

  https://en.wikipedia.org/wiki/Preterm_birth

  Preterm birth may be prevented in those at risk if the hormone progesterone is taken during pregnancy. Evidence does not support the usefulness of bed rest to prevent preterm labor. […] In women who might deliver between 24 and 37 weeks, corticosteroid treatment may improve outcomes. […] Identifying women at high risk of giving birth early would enable the health services to provide specialized care for these women and their babies, for example a hospital with a special care baby unit such as a neonatal intensive care unit (NICU). […] The absence of prenatal care has been associated with higher rates of preterm births. […] Placental alpha microglobulin-1 (PAMG-1) has been the subject of several investigations evaluating its ability to predict imminent spontaneous preterm birth in women with signs, symptoms, or complaints suggestive of preterm labor.

• #70 Premature labour and birth – NHS

  https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/premature-labour-and-birth/

  You may be offered treatment to prevent early labour if: you’ve given birth at less than 34 weeks pregnant before, you’ve had a miscarriage from 16 weeks pregnant before, your waters have broken before 37 weeks in a previous pregnancy, your cervix has been injured in the past, for example through surgery. […] Babies born before full term (before 37 weeks) are vulnerable to problems associated with being born premature. The earlier in the pregnancy a baby is born, the more vulnerable they are. […] If your baby is likely to be delivered early, you should be admitted to a hospital with a neonatal unit.

• #71 Prior Preterm Birth | Riley Children’s Health

  https://www.rileychildrens.org/health-info/prior-preterm-birth

  Early births can pose health risks for both mothers and their children. Approximately one in ten babies are born early, according to the Centers for Disease Prevention and Control. Infants born before 37 weeks of pregnancy (gestation) are considered preterm deliveries. […] Women who deliver a child between 16 to 36 weeks gestation have a higher risk of preterm birth in a later pregnancy. Women with two preterm births have about a 25 to 30 percent chance of another preterm birth in a later pregnancy. African Americans are also at a higher risk; about one in five women of African-American descent will have a preterm birth. […] If a woman has had a prior preterm birth, her pregnancy is considered high-risk. The maternal fetal medicine team at Riley at IU Health provides expert care to help mothers have the healthiest pregnancies and safest deliveries possible.

• #72 PreTRM® Premature Birth Risk Blood Test from Sera

  https://www.pretrm.com/

  1 in 10 babies are born too soon. […] The PreTRM Test is the first of its kind for premature birth. […] The PreTRM Test is the only clinically validated commercially available blood test that provides an early, individual risk assessment for spontaneous preterm birth in asymptomatic, singleton pregnancies. […] Working together we can address problems of preterm birth. […] Understanding if your pregnancy is at higher risk for spontaneous preterm birth allows you and your physician to adjust your treatment plans accordingly. […] The PreTRM Test is a new tool providers and their patients can use to identify and address those at higher risk to improve outcomes. […] The AVERT PRETERM Trial demonstrated a significant reduction in the time the baby spent in the hospital and an 18% reduction in severe neonatal morbidity and mortality when higher-risk pregnancies identified by the PreTRM Test received risk-reduction interventions compared to standard care.

• #73 The Effects of Preterm Labor and Spontaneous Preterm Birth

  https://www.pretrm.com/for-moms/healthy-pregnancy-blog/premature-delivery/effects-of-preterm-labor-and-spontaneous-preterm-birth/

  With advances in pregnancy care knowledge, some cases of preterm birth can be prevented. […] Knowing your individual risk for preterm birth is important in planning for a healthy pregnancy. […] Preterm birth is an important pregnancy complication, affecting about one in ten pregnancies. It’s important to understand the effects of prematurity on babies and families, and to do all you can to understand your risks, prevent premature labor, and give your baby a great start in life.

• #74 Preterm labor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/preterm-labor/diagnosis-treatment/drc-20376848

  Cervical cerclage may be used for people who are less than 24 weeks pregnant, who have a history of early premature birth, and who have a cervix that is opening or a cervical length that is less than 25 millimeters, called a short cervix. […] For a short cervix diagnosed before 24 weeks of pregnancy, progesterone that goes into the vagina might lower the risk of preterm birth. […] Tocolytics can delay preterm labor for 48 hours. This delay can give corticosteroids time to work. Or, if needed, the delay gives you time to get to a hospital that can treat premature babies. […] Preterm labor puts your baby at risk. Work with your healthcare team to improve your chance of a healthy outcome.

• #75 Premature Birth, Management, Complications | IntechOpen

  https://www.intechopen.com/chapters/77092

  The main interventions suggested for the prevention of premature birth are the cervical cerclage, the use of cervical pessary, the use of progesterone orally, subcutaneously or transvaginally, and for treatment administration of tocolytic medication as an attempt to inhibit childbirth for at least 48 hours to make corticosteroids more effective. […] Despite the positive results in reducing mortality and morbidity of premature infants, the need for more research in the field of prevention, investigation of the genital code and the mechanism of initiation of preterm birth is important.

• #76 Preterm Labor Diagnosis | NYU Langone Health

  https://nyulangone.org/conditions/preterm-labor/diagnosis

  Preterm labor happens when a womans body prepares for birth before the baby is considered full term, which is 37 weeks into the pregnancy. Doctors monitor for signs that labor may be taking place before the babys due date. […] Contact your doctor if you have symptoms of labor while pregnant; you may be advised to go to the doctors office or to the hospital. From there, your doctor can determine whether you are in labor. […] The symptoms of preterm labor dont always mean a baby is delivered prematurely. […] To confirm that preterm labor is taking place, your doctor conducts a pelvic exam to determine whether your cervix has begun to dilate, or open, to prepare for birth. […] If you are experiencing regular contractions before 34 of pregnancy, your doctor may swab the cervix and test the secretions for fetal fibronectin. […] If youre experiencing the symptoms of labor before week 37 of pregnancy, your doctor may ask for a urine sample in order to check for a bladder or urinary tract infection, which can lead to preterm contractions.

• #77

  https://journals.lww.com/greenjournal/fulltext/2016/10000/practice_bulletin_no__171__management_of_preterm.61.aspx

  Preterm birth is the leading cause of neonatal mortality and the most common reason for antenatal hospitalization. In the United States, approximately 12% of all live births occur before term, and preterm labor preceded approximately 50% of these preterm births. Although the causes of preterm labor are not well understood, the burden of preterm births is clear; preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths as well as 25-50% of cases of long-term neurologic impairment in children. The diagnosis of preterm labor generally is based on clinical criteria of regular uterine contractions accompanied by a change in cervical dilation, effacement, or both, or initial presentation with regular contractions and cervical dilation of at least 2 cm. Less than 10% of women with the clinical diagnosis of preterm labor actually give birth within 7 days of presentation. It is important to recognize that preterm labor with intact membranes is not the only cause of preterm birth; numerous preterm births are preceded by either rupture of membranes or other medical problems necessitating delivery.

• #78 Definition and Diagnosis of Preterm Labor | SpringerLink

  https://link.springer.com/chapter/10.1007/978-981-13-9875-9_2

  Preterm birth is the leading cause of neonatal mortality and morbidity, as well as the most common reason for antenatal maternal hospitalization. Preterm labor is defined as regular uterine contractions associated with cervical changes (cervical dilatation 2 cm and effacement) that start before 37 weeks of gestation. However, the diagnosis of threatened preterm labor is imprecise to identify women who will give birth preterm infants in near future. […] Prospective studies show that shorter cervical length (1530 mm or less) is significantly associated with spontaneous preterm delivery. Systematic reviews show that fetal fibronectin measurement combined with shorter cervical length has a high negative predictive value (98%) for delivery within 7 days but a low positive predictive value (3050%). The prenatal caregivers should take full advantage of the high negative predictive value of the combined test for women with threatened preterm birth.

• #79 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth – Preterm Birth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11373/

  The diagnosis and treatment of preterm labor is currently based on an inadequate literature. Not only is there a paucity of well-designed and adequately powered clinical trials, but there is incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor. To date, there is no single test or sequence of assessment measures to accurately predict preterm birth. […] The ultimate goal of treatment for preterm labor is to eliminate or reduce perinatal morbidity and mortality. Thus, despite several interventions designed to inhibit preterm labor and prolong pregnancy, the frequency of preterm birth continues to pose a major barrier to the health of newborns worldwide. […] The methods for the diagnosis and treatment of preterm labor are based on an inadequate literature that is compromised not only by the oft-cited paucity of well-designed and adequately powered clinical trials but also, even more, by an incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor, such as progressive cervical dilatation and ruptured membranes.

• #80 SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth | Preterm Birth: Causes, Consequences, and Prevention | The National Academies Press

  https://nap.nationalacademies.org/read/11622/chapter/13

  The methods for the diagnosis and treatment of preterm labor are based on an inadequate literature that is compromised not only by the oft-cited paucity of well-designed and adequately powered clinical trials but also, even more, by an incomplete understanding of the sequence and timing of events that precede clinical evidence of preterm labor, such as progressive cervical dilatation and ruptured membranes. […] Useful studies of methods for the prevention or arrest of preterm labor therefore depend on the development of more accurate methods for the diagnosis of preterm labor. […] The accurate diagnosis of early preterm labor is difficult because the symptoms and signs of preterm labor commonly occur in healthy women who do not deliver preterm and because digital examination of the cervix in early labor is not highly reproducible.

• #81 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth – Preterm Birth – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK11373/

  Barriers to improved accurate diagnosis before treatment is initiated include a lack of professional and public education about the parturitional process and the risks of preterm birth for the infant, inadequate training of medical professionals other than physicians to perform the appropriate examinations, and medicolegal fears that failure to treat a pregnant woman who may be in labor may invite lawsuits.

• #82

  https://www.who.int/news-room/fact-sheets/detail/preterm-birth

  An estimated 13.4 million babies were born preterm in 2020 (before 37 completed weeks of gestation) (1). […] Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for approximately 900 000 deaths in 2019 (2). […] Babies may be born preterm because of spontaneous preterm labour or because there is a medical indication to plan an induction of labour or caesarean birth early. […] Approximately 900 000 children die in 2019 of complications of preterm birth (1). Many survivors face a lifetime of disability, including learning disabilities and visual and hearing problems. […] More research is needed to determine the causes and mechanisms of preterm birth. […] If a woman experiences preterm labour or is at risk of preterm childbirth, treatments are available to help protect the preterm baby from future neurological impairment as well as difficulties with breathing and infection.

• #83 Frontiers | Assessment of current biomarkers and interventions to identify and treat women at risk of preterm birth

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1414428/full

  Currently available risk factor and screening strategies include: Clinical risk factors. As noted, the history of prior preterm birth is one of the most predictive risk factors for preterm birth. […] The complexities of the etiology of preterm birth create a major clinical diagnostic and management dilemma. […] Risk scoring systems based on personal/epidemiologic risk factors have traditionally performed poorly. […] Currently available tests have good test performance as a “rule-out” test to identify those not at risk for preterm birth. The test performance to identify those at greatest risk is modest and does not identify the majority of patients who will have preterm birth in otherwise low risk populations. […] Further research into development of pathway-specific biomarkers and pathway-specific intervention is urgently needed to reduce the global burden of preterm birth.

• #84 Frontiers | Assessment of current biomarkers and interventions to identify and treat women at risk of preterm birth

  https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1414428/full

  Currently available risk factor and screening strategies include: Clinical risk factors. As noted, the history of prior preterm birth is one of the most predictive risk factors for preterm birth. […] The complexities of the etiology of preterm birth create a major clinical diagnostic and management dilemma. […] Risk scoring systems based on personal/epidemiologic risk factors have traditionally performed poorly. […] Currently available tests have good test performance as a “rule-out” test to identify those not at risk for preterm birth. The test performance to identify those at greatest risk is modest and does not identify the majority of patients who will have preterm birth in otherwise low risk populations. […] Further research into development of pathway-specific biomarkers and pathway-specific intervention is urgently needed to reduce the global burden of preterm birth.

• #85 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  PTB/PTL risks can be predicted early using conventional and advanced procedures. […] The earlier reviews mainly concentrated on establishing a relationship between PTB and adult mortality, the impact of high temperatures during pregnancy, other risk variables, and inflammation. However, no one has systematically reviewed the guiding principles and evolving technologies for the early detection of PTB and associated POCT devices available in the market. […] Following an overview of PTB and its current global status, the present review addresses the early diagnosis of PTB using traditional and advanced techniques. […] The current methods for predicting PTB are mainly based on hypothesis-based identification of the risks under a controlled set-up, which may include age at pregnancy, multiple gestations, smoking, drugs or alcohol consumption, infections, and chronic illnesses.

• #86 SECTION III Diagnosis and Treatment of Preterm Labor: 9 Diagnosis and Treatment of Conditions Leading to Spontaneous Preterm Birth | Preterm Birth: Causes, Consequences, and Prevention | The National Academies Press

  https://nap.nationalacademies.org/read/11622/chapter/13

  Other means of enhancing diagnostic accuracy in preterm labor include transvaginal sonographic measurement of cervical length and testing for fetal fibronectin in cervicovaginal fluid. […] Despite evidence that the overdiagnosis of preterm labor in women with frequent contractions is common and results in unnecessary treatment, the clinical use of the fibronectin test and cervical sonography is not widespread. […] The current uncertainty is reflected by the division of clinicians into two camps: those who believe that nothing works and others who claim great success with various interventions. The truth likely falls somewhere in between but will emerge only if additional resources are devoted to improving the means of diagnosis of preterm labor.

• #87 Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor

  https://www.mdpi.com/2306-5354/11/2/161

  AI/ML utilizes the electronic health record (EHR) or pre-defined clinical risk factors for better predictive performance. […] The point-of-care testing (POCT) devices must be “ASSURED” (affordable, sensitive, specific, user friendly, rapid, robust, equipment free, and delivered). […] The market size for PTB diagnostic test kits is predicted to grow from an estimated USD 419 million in 2022 to USD 857 million by 2032. […] The early prediction of the PTB is the major challenge that can help to reduce miscarriage cases and the associated PTB complications later in life for premature babies. […] The usage of diagnostic markers has several drawbacks, one of which is the potential for false negative diagnoses, which can increase the fetus’s risk of morbidity and death. […] The PTB rate was significantly reduced by 45% before 33 weeks of gestation for women with short cervical lengths who applied vaginal progesterone gel. […] The individual with an identified PTB risk should be admitted to a hospital, if necessary, and treated with tocolytics for delaying PTL, corticosteroids for avoiding perinatal complications, or hormonal supplements for maintaining pregnancy.

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