Materiały źródłowe

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

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

  If you’re at risk of preterm labor, your healthcare team may suggest ways to keep labor from starting too soon. […] During a procedure called cervical cerclage, the cervix is stitched closed with strong sutures. Most often, a member of your healthcare team removes the sutures after 36 weeks of pregnancy. If needed, the sutures can be removed earlier. […] 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. […] No medicines or surgeries can stop labor, except briefly. But your healthcare team might suggest the following medicines:

• #1 Treatments for preterm labor | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/treatments-preterm-labor

  Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend some treatments that may help stop your contractions and prevent health problems for you and your baby. They arent guaranteed, but research shows that they do help some people. […] Antenatal corticosteroids (also called ACS). These include medicines such as betamethasone and dexamethasone. These speed up your babys lung development. They also help reduce your babys chances of having certain health problems after birth, including respiratory distress syndrome (also called RDS), intraventricular hemorrhage (also called IVH) and necrotizing enterocolitis (also called NEC). […] Antibiotics. These medicines, which include ceftriaxone, clarithromycin, and metronidazole, kill infections caused by bacteria. If you have a positive Group B strep test, or if you have preterm premature rupture of membranes (also called PPROM), your health care provider may give you antibiotics to help prevent infections in you and your baby.

• #1 What treatments are used to prevent preterm labor and birth? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/preterm/conditioninfo/treatments

  Currently, treatment options for preventing preterm labor or birth are somewhat limited, in part because the cause of preterm labor or birth is often unknown. But there are a few options, described in the following sections. […] Hormone treatment. Progesterone, a hormone produced by the body during pregnancy, was thought to prevent preterm birth in certain groups at high risk of preterm birth, such as those with a prior preterm birth. […] NICHDs Maternal-Fetal Medicine Units Network found that progesterone given to women at risk of preterm birth due to a prior preterm birth reduces chances of a subsequent preterm birth by one-third, when started at 16 weeks of gestation and continued to 37 weeks of gestation. […] Because subsequent research did not show the same effect, use of progesterone to prevent preterm birth is now under review by the U.S. Food and Drug Administration.

• #1 Care for Preterm Birth Complications – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-complications/preterm-birth

  Medications that stop contractions (tocolytics) are helpful when receiving the course of steroid injections over 48 hours, but they are not recommended for long-term use during pregnancy. […] Vaginal progesterone is helpful in pregnancies with a short cervix and high risk of preterm delivery. […] Intramuscular progesterone is a proven therapy for the prevention of recurrent preterm birth. […] Minimally invasive surgical interventions include: Pessary This device is a soft, flexible ring that is placed inside of the mothers vagina by her obstetric care provider to help prevent preterm labor in those patients who are at higher risk, including those with a shorter cervix. […] Cerclage placement of an encompassing suture around the cervix may be appropriate for some women who have a history of a prior mid pregnancy loss, or if during a current pregnancy ultrasound surveillance or physical exam indicates notable shortening or opening of the cervix.

• #1 Preterm Labor: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4498-premature-labor

  Preterm labor may result in premature birth (being born early). However, labor can often be stopped to allow the fetus more time to grow and develop in the uterus. Treatments to stop premature labor include bed rest, intravenous (in your vein) fluids and medicines to relax your uterus. […] If you’re in premature labor, you might need medicine to slow or stop labor. If the labor has progressed and can’t be stopped, your provider may need to deliver the fetus early. There are also medications to help the fetus’s lungs and organs if they’re born early. […] The goal of medication is to stop labor from progressing and give the fetus as much time as possible to grow. The following medications treat preterm labor: Tocolytics: This medication stops contractions for up to 48 hours to delay preterm birth. Once labor is delayed, your provider can give you magnesium sulfate or corticosteroids. This also gives them time to transfer you to a hospital with a neonatal intensive care unit (NICU).

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

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

  Corticosteroids can help lower health risks when a baby is born preterm. This includes lowering the baby’s risk of lung problems, bleeding in the brain, severe infection, called sepsis, and even death. Your healthcare team likely will suggest corticosteroids if you are less than 37 weeks pregnant and thought to be at higher risk of delivery in the next 1 to 7 days. […] Your healthcare team might offer magnesium sulfate if you have a high risk of delivering between weeks 24 and 32 of pregnancy. Some research has shown that it might lower the risk of a certain type of damage to the brain, called cerebral palsy, for babies born before 32 weeks. […] Tocolytics can slow contractions for a while. 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. […] If you’re at risk of preterm labor and you’re not in a hospital, you might need to see your healthcare team weekly or more often. This is so your team can watch for symptoms of preterm labor.

• #1 Preterm Labor and Birth Treatment & Management: Goals of Management, Preconception Strategies to Reduce Risk of Preterm Delivery, Prediction and Risk Assessment for Preterm Delivery

  https://emedicine.medscape.com/article/260998-treatment

  However, the most common tocolytic agents used for the treatment of preterm labor in the United States are nifedipine, indomethacin, and magnesium sulfate. […] Magnesium sulfate was once widely used in the United States as the primary tocolytic agent owing to its similar efficacy to terbutaline and superior tolerance. […] ACOG recommends magnesium sulfate for women at risk of preterm delivery before 32 weeks to reduce the risk of cerebral palsy. […] The administration of antenatal corticosteroids to patients at risk for preterm delivery significantly reduces the risks of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death in infants born preterm. […] When preterm delivery is anticipated within the next 7 days, corticosteroids should be administered.

• #1 Premature Labour: Causes, Symptoms, and Treatment

  https://patient.info/doctor/premature-labour-pro

  Tocolytic drugs […] Consider nifedipine for tocolysis if between 24+0 and 25+6 weeks with intact membranes and suspected preterm labour. […] Offer nifedipine for tocolysis if between 26+0 and 33+6 weeks with intact membranes and suspected or diagnosed preterm labour. […] If nifedipine is contra-indicated, offer oxytocin receptor antagonists for tocolysis. […] Do not offer betamimetics for tocolysis. […] Corticosteroids […] NICE recommends: […] If between 22+0 and 23+6 weeks and suspected or established preterm labour, and planned preterm birth or P-PROM, discuss the use of maternal corticosteroids in the context of individual circumstances. […] Offer maternal corticosteroids if between 24+0 and 33+6 weeks with suspected, diagnosed or established preterm labour, and planned preterm birth or have P-PROM.

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

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

  The treatment strategies used to treat women diagnosed with preterm labor are reviewed below. […] The ultimate goal of treatment for preterm labor is to eliminate or reduce perinatal morbidity and mortality. No trials of the efficacies of tocolytics of sufficient sample size are available to assess these outcomes. The surrogate or secondary outcomes used instead of neonatal morbidity are pregnancy prolongation, frequency of preterm birth, and gestational age at birth. Few placebo-controlled trials of tocolytic drugs have been conducted. -Adrenergic receptor agonists, indomethacin, and atosiban have demonstrated superiority over placebo in achieving limited pregnancy prolongation. The findings of other of the efficacies of tocolytics have been less persuasive and have included those that have compared two active agents, that enroll women at a very low risk of preterm delivery, and that have had an inadequate power to demonstrate any statistically significant difference between agents.

• #1 Pharmacologic Management of Preterm Labor and Prevention of Preterm Birth

  https://www.uspharmacist.com/article/pharmacologic-management-of-preterm-labor-and-prevention-of-preterm-birth

  Tocolytic drugs inhibit uterine contractions. Four main classes of tocolytics, with varying degrees of safety and effectiveness, are used: beta-adrenergic agonists, magnesium sulfate, calcium channel blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs). Despite widespread use, tocolysis lacks robust evidence for the prevention of preterm birth. Most tocolytic drugs prolong gestation for 2 to 7 days. This delay in preterm birth allows sufficient time for the administration of corticosteroids and maternal transfer to a hospital with an appropriate NICU, if such interventions are warranted. […] Maternal progesterone declines before labor, and low maternal progesterone levels are associated with miscarriage and preterm labor. Exogenous progesterone supplementation is indicated for women at risk for preterm labor and birth. Specifically, progesterone lowers the risk of preterm labor and birth by maintaining uterine inactivity. Administered as weekly intramuscular injections of 250 mg of 17-alpha-hydroxyprogesterone caproate (17-OHPC), progesterone reduces the risk of recurrent preterm birth by up to 50% when begun between 16 and 20 weeks gestation. Natural progesterone vaginal suppositories reduce the risk of preterm birth by up to 45% and decrease the incidence of respiratory distress and neonatal morbidity and mortality in pregnant women with a shortened cervix.

• #1 Preterm Labor and Birth Treatment & Management: Goals of Management, Preconception Strategies to Reduce Risk of Preterm Delivery, Prediction and Risk Assessment for Preterm Delivery

  https://emedicine.medscape.com/article/260998-treatment

  The recommended dosage of betamethasone is two 12-mg doses administered 24 hours apart. […] ACOG recommends that all patients who present with preterm labor undergo a vaginal-rectal swab for group B Streptococcus (GBS) culture and receive prophylactic antibiotics against GBS, continued until delivery. […] Antenatal magnesium sulfate should be considered for patients at high risk of delivery before 34 weeks gestation, mainly in those with premature rupture of membranes, active labor, and planned delivery within 24 hours.

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

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

  The one intervention that reduces perinatal morbidity and mortality and that is firmly supported by the findings of research is the antenatal administration of glucocorticoids to women at risk of preterm birth. A 1994 National Institutes of Health Consensus Conference recommended the administration of corticosteroids to women with preterm labor before 34 weeks of gestation and women with PPROM before 32 weeks of gestation by the use of a single course of either betamethasone or dexamethasone. Studies have shown conclusively that the antepartum administration of the glucocorticoids betamethasone or dexamethasone to the mother reduces the risk of death, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and patent ductus arteriosus in the preterm neonate.

• #1 Premature Labour: Causes, Symptoms, and Treatment

  https://patient.info/doctor/premature-labour-pro

  Give a 4 g intravenous bolus of magnesium sulfate over 15 minutes, followed by an intravenous infusion of 1 g per hour until the birth or for 24 hours (whichever is sooner). Monitor for clinical signs of magnesium toxicity at least every four hours by recording pulse, blood pressure, respiratory rate and deep tendon (eg, patellar) reflexes. […] If a woman has or develops oliguria or other evidence of renal failure, monitor more frequently for magnesium toxicity, and reduce or stop the dose of magnesium sulfate. […] Emergency cervical cerclage […] Aims to delay the birth, and so increase the likelihood of the baby surviving and of reducing serious neonatal morbidity. […] Do not offer emergency cervical cerclage to women with signs of infection, active vaginal bleeding, or uterine contractions.

• #1 Premature Infant – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/premature-infant

  Treatment will depend on your childs symptoms, age and general health. It will also depend on how severe the condition is. […] Treatment may include: […] Your healthcare provider may give you the hormone progesterone if you are at high risk for preterm birth. Progesterone can help if you have had a past preterm birth. […] Premature babies are cared for by a neonatologist. This is a doctor with special training to care for newborns. Other specialists may also care for babies, depending on their health problems. […] 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. […] Premature babies often need time to catch up in both development and growth. In the hospital, this catch-up time may mean learning to eat and sleep, as well as steadily gaining weight. […] 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). You should always put your baby down to sleep on their back.

• #1 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. […] Preterm infants often need help with: Breathing. Feeding. Gaining weight. Maintaining their own body temperatures. […] If you go into preterm labor, your healthcare provider may recommend certain medications to stop or delay labor. If those medications dont work, other medications may help prepare the baby for birth and prevent some medical complications. […] The best way to prevent premature birth is to attend all of your prenatal appointments, manage any underlying health conditions and live a healthy lifestyle during pregnancy.

• #1 Prematurity Treatment & Management: Approach Considerations, Medical Care, Diet

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

  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. […] Principles of respiratory management are as follows: Recruit and maintain adequate lung volume or optimal lung volume. In infants with respiratory distress, this step may be accomplished with early continuous positive airway pressure (CPAP) given nasally, by nasal mask, or by using an endotracheal tube when ventilation and/or surfactant is administered. […] Administer surfactant early (age 2 hours) when indicated. Routine use of prophylactic surfactant solely for prematurity is not advisable. […] Early use of CPAP with subsequent selective use of surfactants: Compared with routine intubation with prophylactic or early surfactant therapy, early postnatal CPAP in extremely preterm infants reduces the rates of bronchopulmonary dysplasia and death.

• #1 Treatment for Prematurity | PortalCLÍNIC

  https://www.clinicbarcelona.org/en/assistance/diseases/prematurity/treatment

  Being born preterm is a circumstance, not a disease in itself, although it may lead to persistent complications. […] Preterm babies need special nutrition for ideal growth, if we consider that to be what would have happened if the pregnancy had reached full term. […] For the first few days of their lives, preterm babies born at weeks 31-32 and with a birth weight of less than 1250-1500 g approximately, need intravenous parenteral nutrition, in other words, administered via a central catheter. […] However, it is very important to initiate enteral feeding (through the digestive tract) in the first hours of life, if the newborn is stable. […] The best food for all newborns, and even more so for preterm babies, is the milk of their own mother, as this provides many factors that diminish the risk of various complications.

• #1 Prematurity Treatment & Management: Approach Considerations, Medical Care, Diet

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

  Maintenance of the neutral thermal environment is critical for minimizing stress and optimizing growth of all newborns, but especially for premature infants. […] Preterm infants require intense monitoring of their fluid and electrolyte levels because of their increased transdermal water loss, immature renal function, and other environmental issues (eg, radiant warming, phototherapy, mechanical ventilation). […] A multistakeholder group of newborn health advocates proposed accelerating global kangaroo mother care (KMC) as the standard of care for preterm infants. […] A meta-analysis indicated that dexamethasone use in preterm infants may have significant deleterious effects on hearing and intelligence. […] Discharge criteria in cases of prematurity are as follows: The parents and/or caregivers are capable. That is, they demonstrate an ability to meet the needs of the infant. The patient’s caloric intake is adequate for growth. The patient has been weaned from the supplemental heat. Medical problems are defined and manageable at home. No apnea or bradycardia is present for some time.

• #1

  https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Health-Issues-of-Premature-Babies.aspx

  Because premature babies are born before they are physically ready to leave the womb, they often face some health problems. That’s why preemies are given extra medical attention and help immediately after delivery. […] The neonatologist can help determine what, if any, special treatment your newborn needs. […] Doctors can treat some premature babies with artificial surfactants. In addition a high-flow nasal canula, continuous positive airway pressure (CPAP) machine, or breathing machine (ventilator) can help them breathe better and keep blood oxygen levels up. […] To treat apnea, your baby may get caffeine, extra oxygen through a small tube in the nose (called a nasal cannula), or breathing support with CPAP. In more serious cases, a breathing machine may be needed. […] In most babies, ROP gets better on its own without any treatment. But in more serious cases, doctors might need to treat it using laser surgery or special eye injections.

• #1

  https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Health-Issues-of-Premature-Babies.aspx

  There is no specific treatment for IVH, except to treat any other health problems that may worsen the condition. […] Treatment for NEC involves stopping feedings for 5 to 10 days and giving antibiotics. If it is severe, surgery may be needed. […] Treating jaundice involves placing the undressed baby under special lights (while their eyes are covered to protect them). […] When a premature baby is in the NICU, the team may refer a child at risk for developmental delays for services such as feeding therapy, speech or physical therapy.

• #1 Getting services for your baby after the NICU | March of Dimes

  https://www.marchofdimes.org/find-support/topics/neonatal-intensive-care-unit-nicu/getting-services-your-baby-after-nicu

  Babies who were born early or with certain medical conditions may be more likely to experience developmental delays. […] Early intervention programs provide services for babies and children who have or who are likely to have developmental delays. […] Early intervention programs often include physical therapy, occupational therapy, and speech therapy. […] You or your babys provider can request additional services to check for developmental delays. […] If your baby is eligible for these services, an Individualized Family Service Plan (IFSP) is created.

• #1 Facts About Premature Birth: Prevention and Treatment – CHOC Children’s

  https://choc.org/articles/facts-about-premature-birth-prevention-treatment/

  Babies born extremely early are at a higher risk for intellectual disabilities, cerebral palsy, breathing problems and death. Parents should ask their neonatologist and pediatrician about medical issues to watch for as their preemie grows. […] Keeping up with vaccinations is important for preemies. This will protect the baby until his or her immune system has matured. […] Premature babies are at risk for developmental delays. Parents should watch carefully to see if their baby hits his or her milestones, taking into account the appropriate delay from an early birth. […] If a woman thinks she will deliver prematurely, it is important to make a birth plan that includes partnering with a hospital that has experience treating premature babies.

• #1 Premature Infant: Causes, Complications, and More

  https://www.healthline.com/health/pregnancy/premature-infant

  Common long-term problems associated with premature birth, especially extreme prematurity, include: […] Parents of premature infants need to pay careful attention to their childs cognitive and motor development. This includes the achievement of certain skills, such as smiling, sitting, and walking. […] Speech and behavioral development also are important to monitor. Some premature infants may need speech therapy or physical therapy throughout their childhood.

• #1 Genetic Discovery Reveals Who Can Benefit from Preterm Birth Therapy | UC San Francisco

  https://www.ucsf.edu/news/2024/01/426976/genetic-discovery-reveals-who-can-benefit-preterm-birth-therapy

  A UC San Francisco-led study has for the first time identified genetic variants that predict whether a patient is likely to respond to treatment for preterm birth, a condition that affects 1 in 10 infants born in the United States. […] The findings suggest a personalized medicine approach involving genetic screening could lead to successful results in patients without a high burden of those mutations. […] Progesterone therapy was the only treatment for recurrent preterm birth over the past decade, and its recent withdrawal by the FDA has left a void in the medication options available for preterm birth patients, said the study’s first author, Cheng Wang, PhD, a postdoctoral scholar at UCSF. […] Many of these therapeutic compounds are already being used to treat cancer and other diseases, which means that these drugs could possibly be repurposed to help prevent preterm labor. A top candidate is the small molecule RKI-1447, a drug that is currently being used to treat cancer, glaucoma and fatty liver disease. Additional study of the potential of these molecules in treating preterm birth is needed.

• #1 Treatment hope for premature babies – Hudson Institute of Medical Research

  https://www.hudson.org.au/news/treatment-hope-for-premature-babies/

  A treatment offering hope to parents of very premature babies is showing great promise, in the first worldwide stocktake of research into umbilical cord blood stem cells. […] Researchers from Hudson Institute of Medical Research have compiled the first comprehensive review of research using umbilical cord blood and cord-tissue stem cells to treat diseases in premature babies, and found their uses to be widespread and with evidence of benefit. […] According to lead author Dr Lindsay Zhou, umbilical cord blood and cord-tissue derived cells have been given to a total of 206 premature babies worldwide so far in 12 clinical trials. These trials show that cord blood and cord tissue cell treatments are safe for premature babies. […] They are being used to treat conditions in premature babies such as birth asphyxia, chronic lung disease of prematurity, congenital heart disease, and injuries to the preterm brain, Dr Zhou said.

• #1 How music therapy helped my premature baby | PBS News

  https://www.pbs.org/newshour/health/music-therapy-helped-premature-baby

  On his second day of life, while I was sitting next to my sons isolette, a woman approached me. She described herself as a NICU music therapist. […] She claimed that her work could potentially reduce Bradleys days in the NICU. This idea of music therapy helping premature babies weighing as little as a pound reduce their days in the NICU sparked my curiosity. […] A study published in the journal Pediatrics in 2013 that proved music therapy can improve a preemies breathing, heart rate, feeding and sleep and, in some cases, possibly reduce the number of days in the NICU. […] Music therapy can improve a preemies breathing, heart rate, feeding and sleep and, in some cases, possibly reduce the number of days in the NICU. […] We want to enhance a parents capacity to bond, because we want the parents to be able to know what to do when the baby is irritable, said Joanne Loewy, founder of the Louis Armstrong Center for Music and Medicine.

• #1 New medicines for spontaneous preterm birth prevention and preterm labour management: landscape analysis of the medicine development pipeline | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05842-9

  There are few medicines in clinical use for managing preterm labor or preventing spontaneous preterm birth from occurring. […] The AIM database identified 178 candidates. Of the 71 candidates in clinical development, ten were deemed high potential (Prevention: Omega-3 fatty acid, aspirin, vaginal progesterone, oral progesterone, L-arginine, and selenium; Treatment: nicorandil, isosorbide dinitrate, nicardipine and celecoxib) and seven were medium potential (Prevention: pravastatin and lactoferrin; Treatment: glyceryl trinitrate, retosiban, relcovaptan, human chorionic gonadotropin and Bryophyllum pinnatum extract). […] Fewer options are available for preventing spontaneous preterm birth while vaginal progesterone can prevent preterm birth in high-risk women (women a history of spontaneous preterm birth or shortened cervix), some clinical indications for use (short cervical length, detected via ultrasound) are not easy to identify in all settings.

• #1 CDC Grand Rounds: Public Health Strategies to Prevent Preterm Birth | MMWR

  https://www.cdc.gov/mmwr/volumes/65/wr/mm6532a4.htm

  Several initiatives are underway to reduce preterm delivery and complications. […] Expanding the success of state-based PQCs is another ongoing initiative. […] During the past decade, considerable advances have been made in medical care for preterm infants, along with corresponding reductions in infant mortality. Continued efforts to reduce preterm birth and its associated racial and ethnic disparities are critical for further reduction of the U.S. infant mortality rate.

• #2 Preterm Labor: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4498-premature-labor

  Preterm labor may result in premature birth (being born early). However, labor can often be stopped to allow the fetus more time to grow and develop in the uterus. Treatments to stop premature labor include bed rest, intravenous (in your vein) fluids and medicines to relax your uterus. […] If you’re in premature labor, you might need medicine to slow or stop labor. If the labor has progressed and can’t be stopped, your provider may need to deliver the fetus early. There are also medications to help the fetus’s lungs and organs if they’re born early. […] The goal of medication is to stop labor from progressing and give the fetus as much time as possible to grow. The following medications treat preterm labor: Tocolytics: This medication stops contractions for up to 48 hours to delay preterm birth. Once labor is delayed, your provider can give you magnesium sulfate or corticosteroids. This also gives them time to transfer you to a hospital with a neonatal intensive care unit (NICU).

• #2 What treatments are used to prevent preterm labor and birth? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/preterm/conditioninfo/treatments

  Currently, treatment options for preventing preterm labor or birth are somewhat limited, in part because the cause of preterm labor or birth is often unknown. But there are a few options, described in the following sections. […] Hormone treatment. Progesterone, a hormone produced by the body during pregnancy, was thought to prevent preterm birth in certain groups at high risk of preterm birth, such as those with a prior preterm birth. […] NICHDs Maternal-Fetal Medicine Units Network found that progesterone given to women at risk of preterm birth due to a prior preterm birth reduces chances of a subsequent preterm birth by one-third, when started at 16 weeks of gestation and continued to 37 weeks of gestation. […] Because subsequent research did not show the same effect, use of progesterone to prevent preterm birth is now under review by the U.S. Food and Drug Administration.

• #2 Preterm Labor: Prevention and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/0315/p366.html

  In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. […] Antenatal progesterone is associated with a significant decrease in subsequent preterm delivery in certain pregnant women. Current recommendations are to prescribe vaginal progesterone in women with a shortened cervix and no history of preterm delivery, and to use progesterone supplementation regardless of cervical length in women with a history of spontaneous preterm delivery. […] A course of corticosteroids is the only antenatal intervention that has been shown to improve postdelivery neonatal outcomes, including a reduction in neonatal mortality, intracranial hemorrhage, necrotizing enterocolitis, and neonatal infection. […] When used in specific at-risk populations, magnesium sulfate provides neuroprotection and decreases the incidence of cerebral palsy in preterm infants.

• #2 Treatments to Prevent Premature Birth (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/treatments-prevent-premature-birth.html

  Having a full-term pregnancy is best for your baby’s health. Full-term pregnancies usually last about 40 weeks. When a baby is born earlier than 37 weeks, it’s called a preterm or premature birth. Babies who are born early can have health problems that may last their whole lives. […] In these cases, the doctor may recommend treatments such as: […] Progesterone: This hormone can be given as a shot or put into the vagina. It can help lower the chances of going into labor early for women who have had a premature baby before or who have a short cervix. […] Cerclage: In this procedure, stitches close a woman’s cervix to help prevent preterm birth. Doctors may recommend cerclage for women who have had premature babies or miscarriages, who have a short cervix, or who have a cervix that begins to open (dilate) too early.

• #2 Preterm Labor and Birth Treatment & Management: Goals of Management, Preconception Strategies to Reduce Risk of Preterm Delivery, Prediction and Risk Assessment for Preterm Delivery

  https://emedicine.medscape.com/article/260998-treatment

  In contrast to the studies of 17-OHP, a multicenter randomized controlled trial (the PREGNANT trial) of 90 mg of vaginal progesterone daily for women with sonographically detected short cervices (10-20 mm) between 19 and 23 6/7 weeks demonstrated a 45% reduction in preterm birth. […] Thus, based on this evidence, vaginal progesterone has emerged as the most consistent and effective intervention for reducing preterm birth rates in patients with a short cervix detected during the mid-trimester. […] ACOG further states that in patients with a prior spontaneous preterm birth, cerclage should be considered with a cervical length of less than 25 mm. […] Cervical pessary devices, specifically the Arabin pessary, have received increasing interest for the prevention of preterm birth in women with a short cervix.

• #2 Treatments for preterm labor | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/treatments-preterm-labor

  Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend some treatments that may help stop your contractions and prevent health problems for you and your baby. They arent guaranteed, but research shows that they do help some people. […] Antenatal corticosteroids (also called ACS). These include medicines such as betamethasone and dexamethasone. These speed up your babys lung development. They also help reduce your babys chances of having certain health problems after birth, including respiratory distress syndrome (also called RDS), intraventricular hemorrhage (also called IVH) and necrotizing enterocolitis (also called NEC). […] Antibiotics. These medicines, which include ceftriaxone, clarithromycin, and metronidazole, kill infections caused by bacteria. If you have a positive Group B strep test, or if you have preterm premature rupture of membranes (also called PPROM), your health care provider may give you antibiotics to help prevent infections in you and your baby.

• #2 Treatments for preterm labor | March of Dimes

  https://www.marchofdimes.org/find-support/topics/birth/treatments-preterm-labor

  Tocolytics. These medicines may be used to slow or stop labor contractions. There are several types, including: beta-adrenergic receptor agonists, calcium channel blockers, magnesium sulfate, and nonsteroidal anti-inflammatory drugs, or NSAIDs. Tocolytics may delay labor, often for just a few days. This delay may give you time to get treatment with ACS or to get to a hospital that has a NICU (neonatal intensive care unit). […] Talk with your health care provider about the benefits and risks of medicines.

• #2 Pharmacologic Management of Preterm Labor and Prevention of Preterm Birth

  https://www.uspharmacist.com/article/pharmacologic-management-of-preterm-labor-and-prevention-of-preterm-birth

  Tocolytic drugs inhibit uterine contractions. Four main classes of tocolytics, with varying degrees of safety and effectiveness, are used: beta-adrenergic agonists, magnesium sulfate, calcium channel blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs). Despite widespread use, tocolysis lacks robust evidence for the prevention of preterm birth. Most tocolytic drugs prolong gestation for 2 to 7 days. This delay in preterm birth allows sufficient time for the administration of corticosteroids and maternal transfer to a hospital with an appropriate NICU, if such interventions are warranted. […] Maternal progesterone declines before labor, and low maternal progesterone levels are associated with miscarriage and preterm labor. Exogenous progesterone supplementation is indicated for women at risk for preterm labor and birth. Specifically, progesterone lowers the risk of preterm labor and birth by maintaining uterine inactivity. Administered as weekly intramuscular injections of 250 mg of 17-alpha-hydroxyprogesterone caproate (17-OHPC), progesterone reduces the risk of recurrent preterm birth by up to 50% when begun between 16 and 20 weeks gestation. Natural progesterone vaginal suppositories reduce the risk of preterm birth by up to 45% and decrease the incidence of respiratory distress and neonatal morbidity and mortality in pregnant women with a shortened cervix.

• #2 Preterm birth – Wikipedia

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

  The routine administration of antibiotics to all women with threatened preterm labor reduces the risk of the baby being infected with group B streptococcus and has been shown to reduce related mortality rates. […] A number of medications may be useful to delay delivery including: nonsteroidal anti-inflammatory drugs, calcium channel blockers, beta mimetics, and atosiban. […] Tocolysis rarely delays delivery beyond 24-48 hours. […] Progestogens often given in the form of vaginal progesterone or hydroxyprogesterone caproate relax the uterine musculature, maintain cervical length, and possess anti-inflammatory properties; all of which invoke physiological and anatomical changes considered to be beneficial in reducing preterm birth. […] Cervical cerclage is a surgical intervention that places a suture around the cervix to prevent its shortening and widening.

• #2 Preterm Labor and Birth Treatment & Management: Goals of Management, Preconception Strategies to Reduce Risk of Preterm Delivery, Prediction and Risk Assessment for Preterm Delivery

  https://emedicine.medscape.com/article/260998-treatment

  However, the most common tocolytic agents used for the treatment of preterm labor in the United States are nifedipine, indomethacin, and magnesium sulfate. […] Magnesium sulfate was once widely used in the United States as the primary tocolytic agent owing to its similar efficacy to terbutaline and superior tolerance. […] ACOG recommends magnesium sulfate for women at risk of preterm delivery before 32 weeks to reduce the risk of cerebral palsy. […] The administration of antenatal corticosteroids to patients at risk for preterm delivery significantly reduces the risks of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death in infants born preterm. […] When preterm delivery is anticipated within the next 7 days, corticosteroids should be administered.

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

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

  The one intervention that reduces perinatal morbidity and mortality and that is firmly supported by the findings of research is the antenatal administration of glucocorticoids to women at risk of preterm birth. A 1994 National Institutes of Health Consensus Conference recommended the administration of corticosteroids to women with preterm labor before 34 weeks of gestation and women with PPROM before 32 weeks of gestation by the use of a single course of either betamethasone or dexamethasone. Studies have shown conclusively that the antepartum administration of the glucocorticoids betamethasone or dexamethasone to the mother reduces the risk of death, respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and patent ductus arteriosus in the preterm neonate.

• #2 Steroids for preterm birth | Healthify

  https://healthify.nz/medicines-a-z/s/steroids-for-preterm-birth/

  If a baby is at risk of being born too early (before 35 weeks of pregnancy), giving the mother steroid therapy before the birth can help her unborn baby’s lungs to develop more quickly. This reduces the risk of serious complications or the newborn dying. Steroid therapy is usually given as betamethasone injection (two doses, 24 hours apart). […] A short course of steroid injections may be offered to you to help your baby if there’s a chance that you may give birth early (before 35 weeks of pregnancy). Steroids help develop your baby’s lungs. […] Giving you steroid injections shortly before your baby is born reduces the risk of them having some serious complications including: breathing problems, bleeding in their brain, inflammation of their bowel. […] Steroid therapy is usually offered from 24 to 35 weeks of pregnancy. It’s unlikely to be offered after 35 weeks as your baby’s lungs are likely to be ready for breathing on their own so it’s not needed.

• #2 Steroids for preterm birth | Healthify

  https://healthify.nz/medicines-a-z/s/steroids-for-preterm-birth/

  The steroid, betamethasone is given as an injection into a muscle, usually in your thigh or upper arm. A course is 2 injections, given 24 hours apart. Repeat doses may be given after 7 days from the first course of steroids if your baby is at risk of being born very early, depending on the gestation (weeks of pregnancy) and other factors. […] Steroids are of most benefit if the last dose is given to you between 24 hours and 1 week before the birth of your baby. There may still be some benefit even if your baby is born within 24 hours of the first dose. Steroids are not as effective if your baby is born more than 7 days after the treatment. Even if you’re at risk of giving birth early, you won’t be given steroids unless you’re likely to give birth in the next 7 days. […] A course of steroids is safe for you and your baby. You may experience some minor side effects, eg, pain at the injection site. For most babies born at 23 to 35 weeks, the benefits of steroids are greater than the risks. If you’re given steroid injections, some babies may have: a slightly lower birth weight than average, low blood glucose levels after birth that need extra monitoring and management. Your healthcare team will talk to you about how the risks and benefits of steroids may affect you.

• #2

  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.

• #2 Preterm Labor and Birth | ACOG

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

  Medications that help prepare a fetus for preterm birth include corticosteroids, magnesium sulfate, and tocolytics. […] Corticosteroids can help speed up development of the fetus’s lungs, brain, and digestive organs. […] When given before preterm birth, magnesium sulfate may reduce the risk of cerebral palsy and problems with physical movement. […] Tocolytics are medications used to delay delivery, sometimes for up to 48 hours. If delivery is delayed even a few hours, it may allow more time to give corticosteroids or magnesium sulfate. This delay also may allow time for transfer to a hospital with specialized care for preterm babies. […] If you are at risk of preterm birth, talk with your ob-gyn about treatments that may help prevent it. Treatments may include vaginal progesterone and cerclage.

• #2 Treatments to Prevent Premature Birth (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/treatments-prevent-premature-birth.html

  Care for someone in preterm labor can include: […] Antibiotics: These can treat or prevent infections in the baby and the mother. […] Steroids: These drugs can help speed up a baby’s lung growth and decrease the chances of breathing problems if the baby is born too soon. […] Medicine to slow or stop labor contractions temporarily: Delaying labor even a day or two can be enough time for steroids to help a baby’s lungs develop. […] If you’re pregnant or planning to become pregnant, meet with your doctor. Women who get regular prenatal care are more likely to have a healthier pregnancy and baby.

• #2 Premature Labour: Causes, Symptoms, and Treatment

  https://patient.info/doctor/premature-labour-pro

  Antenatal prophylactic antibiotics for women with P-PROM […] As prophylaxis for intrauterine infection, offer women with P-PROM oral erythromycin 250 mg 4 times a day for a maximum of 10 days or until the woman is in established labour (whichever is sooner). […] For women with P-PROM who cannot tolerate erythromycin or in whom erythromycin is contraindicated, consider an oral penicillin for a maximum of 10 days or until the woman is in established labour (whichever is sooner). […] Do not offer women with P-PROM co-amoxiclav as prophylaxis for intrauterine infection.

• #2 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. […] Tests your premature baby may need include: […] The neonatal intensive care unit (NICU) or special care nursery closely tracks your premature baby’s health. […] This type of care for your baby may include: […] Medicines may be given to your baby for different reasons. […] Sometimes surgery is needed to treat a premature baby’s health problems. […] The following signs mean your baby is ready to go home: […] Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. […] Before you leave the hospital, take a course in infant CPR. […] There are a few options to protect premature babies from severe RSV infection. […] It’s suggested that vaccines be given to premature babies who are in stable health based on their age.

• #2 Premature Infant: Causes, Complications, and More

  https://www.healthline.com/health/pregnancy/premature-infant

  The premature baby may be given oxygen if their lungs arent fully developed. Depending on how well the infant can breathe on their own, one of the following may be used to deliver oxygen: […] Generally, a premature infant can be released from the hospital once they can: […] Premature infants often require special care. This is why they usually begin their lives in an NICU. The NICU provides an environment that limits stress to the baby. It also provides the warmth, nutrition, and protection needed for proper growth and development. […] Due to many recent advances in care for mothers and newborns, survival rates for premature infants have improved. […] Even so, all premature infants are at risk of long-term complications. Developmental, medical, and behavioral problems can continue through childhood. Some may even cause permanent disabilities.

• #2 Premature birth medical therapy – wikidoc

  https://m.wikidoc.org/index.php/Premature_birth_medical_therapy

  To try to reduce the risk of this outcome, pregnant mothers with threatened premature delivery prior to 34 weeks are often administered at least one course of glucocorticoids, a steroid that crosses the placental barrier and stimulates growth in the lungs of the fetus. Typical glucocorticoids that would be administered in this context are betamethasone or dexamethasone, often when the fetus has reached viability at 23 weeks. In cases where premature birth is imminent, a second „rescue” course of steroids may be administered 12 to 24 hours before the anticipated birth. There is no research consensus on the efficacy and side-effects of a second course of steroids, but the consequences of RDS are so severe that a second course is often viewed as worth the risk. […] The required care for premature infants differs greatly depending on the child’s gestational age, birth weight, and overall maturity. Measures common among extremely premature infants include: Placing the infant in a warmer or isolette. Premature infants are easily susceptible to cold-stress or hypothermia and infection, and preventing these is a key priority. Infants under 32 weeks typically do not produce enough surfactant in their lungs to enable them to breathe on their own. In these cases, surfactant will be administered to assist them. A breathing tube may be inserted in the infant’s trachea, and a ventilator and supplemental oxygen may be used. Adequate nutrition, via a feeding tube or, in extremely premature infants, intravenously. If a feeding tube is used, expressed breast milk from the mother or a breastmilk bank can be used, which lowers the risk of infections such as necrotizing enterocolitis.

• #2 Prematurity Treatment & Management: Approach Considerations, Medical Care, Diet

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

  Premature infants born at less than 35 weeks’ gestation have poor coordination of the suck and swallow reflexes and decreased intestinal motility. […] Preterm formulas have been developed to address the specific needs and digestive abilities of the preterm infant. The typical formula contains more easily digested glucose polymers (50% of carbohydrates) and medium chain triglycerides that minimize the need for active lipase activity. […] Guidelines issued in 2013 by the American Academy of Pediatrics offer the first dietary recommendations for vitamin D and calcium intake specifically for preterm infants.

• #2 Treatment for Prematurity | PortalCLÍNIC

  https://www.clinicbarcelona.org/en/assistance/diseases/prematurity/treatment

  After the first few days, different (fortifying) nutrients are added to optimise growth. […] Antibiotics are administered to preterm babies who are at risk of infection during labour, or who acquire an infection while they are in the hospital. […] If the infection is not confirmed, the antibiotics must be withdrawn as quickly as possible. […] They may need help to keep breathing effectively (oxygenation and ventilation): supplemental oxygen, non-invasive or invasive ventilation support, administration of surfactant, and so on. […] If the patient have theses alterations will be required: increased intravascular volume and/or with medication to increase cardiac contractility or the tone of the blood vessels. […] The treatment is specific to each of the different complications.

• #2 Caring for Your Premature Baby at Home (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/preemie-care.html

  Your baby will be discharged with a custom feeding plan and might need extra calories to grow well. Premature babies need more nourishment because they have to catch up to the growth of full-term babies. […] In some cases, premature babies who cannot be fed through the stomach are on total parenteral nutrition (TPN), a solution that contains all the nutrition a baby needs. TPN is given through an IV catheter in the vein. Talk to your care team about whats best for your child. […] Some babies develop a longer-lasting lung condition called bronchopulmonary dysplasia (BPD) (also called chronic lung disease of prematurity), which involves scarring and irritation in the lungs. After they go home, babies with BPD may need extra oxygen and medicines to help their lungs work better. If your baby will need oxygen, equipment for giving it and monitoring your baby at home and during travel will be arranged before discharge. Talk to the care team if you have questions about using this equipment or are concerned about your child’s breathing. […] Research shows that kangaroo care can enhance parentchild bonding, promote breastfeeding, and improve a preemie’s health.

• #2

  https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Health-Issues-of-Premature-Babies.aspx

  Because premature babies are born before they are physically ready to leave the womb, they often face some health problems. That’s why preemies are given extra medical attention and help immediately after delivery. […] The neonatologist can help determine what, if any, special treatment your newborn needs. […] Doctors can treat some premature babies with artificial surfactants. In addition a high-flow nasal canula, continuous positive airway pressure (CPAP) machine, or breathing machine (ventilator) can help them breathe better and keep blood oxygen levels up. […] To treat apnea, your baby may get caffeine, extra oxygen through a small tube in the nose (called a nasal cannula), or breathing support with CPAP. In more serious cases, a breathing machine may be needed. […] In most babies, ROP gets better on its own without any treatment. But in more serious cases, doctors might need to treat it using laser surgery or special eye injections.

• #2 Prematurity Treatment & Management: Approach Considerations, Medical Care, Diet

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

  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. […] Principles of respiratory management are as follows: Recruit and maintain adequate lung volume or optimal lung volume. In infants with respiratory distress, this step may be accomplished with early continuous positive airway pressure (CPAP) given nasally, by nasal mask, or by using an endotracheal tube when ventilation and/or surfactant is administered. […] Administer surfactant early (age 2 hours) when indicated. Routine use of prophylactic surfactant solely for prematurity is not advisable. […] Early use of CPAP with subsequent selective use of surfactants: Compared with routine intubation with prophylactic or early surfactant therapy, early postnatal CPAP in extremely preterm infants reduces the rates of bronchopulmonary dysplasia and death.

• #2 Guide | Physical Therapy Guide to Infant Prematurity | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-infant-prematurity

  Physical therapists design treatment plans to help premature babies develop to their full potential. […] A physical therapist is an important partner for parents of any child born prematurely. Physical therapy should begin as soon as possible after birth, when the baby is healthy enough. […] Your physical therapist will help you understand your premature baby’s needs. They will work with you to learn the safest ways to care for a premature baby. […] Treatment in the NICU will focus on positioning, handling, feeding, and posture. […] Some babies born too early have problems with their development. Your physical therapist will help your child learn to master skills such as holding up their head, sitting up, crawling, pulling themselves up to stand, and walking. […] Research shows that children who participate in fun, early-intervention physical therapy programs can expect to benefit with improved thinking and movement skills. Early-intervention physical therapy may be provided in the home or at another location, such as a hospital or physical therapy outpatient clinic.

• #2 Facts About Premature Birth: Prevention and Treatment – CHOC Children’s

  https://choc.org/articles/facts-about-premature-birth-prevention-treatment/

  Babies born extremely early are at a higher risk for intellectual disabilities, cerebral palsy, breathing problems and death. Parents should ask their neonatologist and pediatrician about medical issues to watch for as their preemie grows. […] Keeping up with vaccinations is important for preemies. This will protect the baby until his or her immune system has matured. […] Premature babies are at risk for developmental delays. Parents should watch carefully to see if their baby hits his or her milestones, taking into account the appropriate delay from an early birth. […] If a woman thinks she will deliver prematurely, it is important to make a birth plan that includes partnering with a hospital that has experience treating premature babies.

• #2 New medicines for spontaneous preterm birth prevention and preterm labour management: landscape analysis of the medicine development pipeline | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05842-9

  There are few medicines in clinical use for managing preterm labor or preventing spontaneous preterm birth from occurring. […] The AIM database identified 178 candidates. Of the 71 candidates in clinical development, ten were deemed high potential (Prevention: Omega-3 fatty acid, aspirin, vaginal progesterone, oral progesterone, L-arginine, and selenium; Treatment: nicorandil, isosorbide dinitrate, nicardipine and celecoxib) and seven were medium potential (Prevention: pravastatin and lactoferrin; Treatment: glyceryl trinitrate, retosiban, relcovaptan, human chorionic gonadotropin and Bryophyllum pinnatum extract). […] Fewer options are available for preventing spontaneous preterm birth while vaginal progesterone can prevent preterm birth in high-risk women (women a history of spontaneous preterm birth or shortened cervix), some clinical indications for use (short cervical length, detected via ultrasound) are not easy to identify in all settings.

• #2 Treatment hope for premature babies – Hudson Institute of Medical Research

  https://www.hudson.org.au/news/treatment-hope-for-premature-babies/

  Umbilical cord blood-derived cell treatment is still in early-phase clinical trials around the world, and there is need for further laboratory and clinical studies to find ways to use them effectively to treat complications of prematurity, Dr Zhou said. […] We hope that umbilical cord blood stem cells can be used like a rescue team, to come in and help premature babies who are injured, and replenish supplies.

• #2 How music therapy helped my premature baby | PBS News

  https://www.pbs.org/newshour/health/music-therapy-helped-premature-baby

  Live music is better than recorded music, since it can adapt to the moment, said music therapist Christine Vaskas. […] Dr. Lisa Eiland, head of neonatal care at Mount Sinai West Hospital, has embraced this type of intervention. She says anytime you can reduce the stress off the patient, it helps with healing and in the case of premature babies, it can help in development. […] Music therapy can help feeding procedures. It is stressful when a baby first tries to learn to eat. Anything to help them take the edge off can help them progress at a faster rate. […] Eiland believes this therapy can be used in any medical situation where there is a pattern of high stress on patients in treatment and recovery. […] As for us, I can attest my son benefited from the music therapy, and we still sing him the songs: Cyndi Laupers True Colors and the Jewish healing prayer Mi Shebierach.

• #2 New medicines for spontaneous preterm birth prevention and preterm labour management: landscape analysis of the medicine development pipeline | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-05842-9

  The lack of innovation in medicines for spontaneous preterm birth/labour can be attributed to the broader, long-standing lack of investment in research and development (RD) for new medicines for obstetric conditions. […] This analysis provides a drug-agnostic approach to assessing the potential of candidate medicines for spontaneous preterm birth. […] We identified six high priority candidates for spontaneous preterm birth prevention (omega-3 fatty acids, aspirin, vaginal and oral progesterone, pravastatin, l-arginine and selenium) and four high priority candidates for management of preterm labour (nicorandil, isosorbide dinitrate, nicardipine and celecoxib), which warrant RD investment.

• #2 Premature Birth, Management, Complications | IntechOpen

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

  In recent years an increase in premature births (PB) rate has been noticed, as this pregnancy complication that still remain an important cause of perinatal morbidity and mortality, is multifactorial and prediction is not easy in many cases. […] According to the latest data, an effective method of successful prevention of premature birth has not been found. 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.

• #3

  https://www.who.int/news-room/fact-sheets/detail/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. These include antenatal steroids and tocolytic treatments to delay labour and antibiotics for preterm prolabour rupture of membranes (PPROM). […] In 2022, WHO also published new recommendations on the care of the preterm infant. These reflect new evidence that simple interventions such as kangaroo mother care immediately after birth, early initiation of breastfeeding, use of continuous positive airway pressure (CPAP) and medicines such as caffeine for breathing problems can substantially reduce mortality in preterm and low birthweight babies. […] WHO regularly updates clinical guidelines for the management of pregnancy and mothers with preterm labour or at risk of preterm birth, and guidelines on the care of preterm and low birth weight babies. […] WHO also supports countries to implement WHO’s guidelines, aimed at reducing the risk of negative pregnancy outcomes, including preterm births, and ensuring a positive pregnancy and postnatal experience for all women and their infants.

• #3 Preterm Labor: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4498-premature-labor

  If you have a history of preterm birth, your obstetrician may recommend medication to prevent you from going into labor too soon. The most commonly used medication is progesterone. It involves inserting a progesterone suppository into your vagina. In some cases, your provider will recommend a cervical cerclage. It’s a procedure in which your cervix is stitched closed to prevent it from dilating.

• #3 What treatments are used to prevent preterm labor and birth? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/preterm/conditioninfo/treatments

  Cerclage. A surgical procedure called cervical cerclage is sometimes used to try to prevent early labor in women who have an incompetent (weak) cervix and have experienced early pregnancy loss accompanied by a painless opening (dilation) of the cervix (the bottom part of the uterus). […] In the cerclage procedure, a doctor stitches the cervix closed. The stitch is then removed closer to the woman’s due date. […] Bed rest. Contrary to expectations, confining the mother to bed rest does not help to prevent preterm birth. In fact, bed rest can make preterm birth even more likely among some women. […] Women should discuss all of their treatment options including the risks and benefits with their health care providers. If possible, these discussions should occur during regular prenatal care visits, before there is any urgency, to allow for a complete discussion of all the issues.

• #3 Pharmacologic Management of Preterm Labor and Prevention of Preterm Birth

  https://www.uspharmacist.com/article/pharmacologic-management-of-preterm-labor-and-prevention-of-preterm-birth

  Tocolytic drugs inhibit uterine contractions. Four main classes of tocolytics, with varying degrees of safety and effectiveness, are used: beta-adrenergic agonists, magnesium sulfate, calcium channel blockers, and nonsteroidal anti-inflammatory drugs (NSAIDs). Despite widespread use, tocolysis lacks robust evidence for the prevention of preterm birth. Most tocolytic drugs prolong gestation for 2 to 7 days. This delay in preterm birth allows sufficient time for the administration of corticosteroids and maternal transfer to a hospital with an appropriate NICU, if such interventions are warranted. […] Maternal progesterone declines before labor, and low maternal progesterone levels are associated with miscarriage and preterm labor. Exogenous progesterone supplementation is indicated for women at risk for preterm labor and birth. Specifically, progesterone lowers the risk of preterm labor and birth by maintaining uterine inactivity. Administered as weekly intramuscular injections of 250 mg of 17-alpha-hydroxyprogesterone caproate (17-OHPC), progesterone reduces the risk of recurrent preterm birth by up to 50% when begun between 16 and 20 weeks gestation. Natural progesterone vaginal suppositories reduce the risk of preterm birth by up to 45% and decrease the incidence of respiratory distress and neonatal morbidity and mortality in pregnant women with a shortened cervix.

• #3

  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.

• #3 Steroids for preterm birth | Healthify

  https://healthify.nz/medicines-a-z/s/steroids-for-preterm-birth/

  If a baby is at risk of being born too early (before 35 weeks of pregnancy), giving the mother steroid therapy before the birth can help her unborn baby’s lungs to develop more quickly. This reduces the risk of serious complications or the newborn dying. Steroid therapy is usually given as betamethasone injection (two doses, 24 hours apart). […] A short course of steroid injections may be offered to you to help your baby if there’s a chance that you may give birth early (before 35 weeks of pregnancy). Steroids help develop your baby’s lungs. […] Giving you steroid injections shortly before your baby is born reduces the risk of them having some serious complications including: breathing problems, bleeding in their brain, inflammation of their bowel. […] Steroid therapy is usually offered from 24 to 35 weeks of pregnancy. It’s unlikely to be offered after 35 weeks as your baby’s lungs are likely to be ready for breathing on their own so it’s not needed.

• #3 Premature labour and birth – NHS

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

  If you’re in premature labour and you’re 24 to 29 weeks pregnant you should be offered magnesium sulphate (through a drip). This can help protect your baby’s brain development. […] You may also be offered it if you’re in labour and 30 to 33 weeks pregnant. This is to protect your baby against problems linked to being born too soon, such as cerebral palsy. […] 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. […] Treatment usually starts before 24 weeks of pregnancy. […] If you have signs of preterm labour, emergency preventative treatment may be considered. Your doctor will discuss the risks and benefits of emergency treatment with you.

• #3 Treatments to Prevent Premature Birth | Dayton Children’s Hospital

  https://www.childrensdayton.org/kidshealth/a/treatments-prevent-premature-birth

  Antibiotics: These can treat or prevent infections in the baby and the mother. […] Steroids: These drugs can help speed up a baby’s lung growth and decrease the chances of breathing problems if the baby is born too soon. […] Medicine to slow or stop labor contractions temporarily: Delaying labor even a day or two can be enough time for steroids to help a baby’s lungs develop. It also gives hospital staff time to get the mother to a hospital with a NICU, if needed. […] Doctors won’t try to stop contractions if the baby is more than 34 weeks and the lungs are developed, or if there are worries about the mother’s or baby’s health.

• #3 Prematurity | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/prematurity

  Premature babies usually need care in a special nursery called the Neonatal Intensive Care Unit (NICU). Children’s NICU combines advanced technology and specially trained doctors and nurses to care for the tiniest patients. Our NICU team is led by a neonatologist, who is a pediatrician with additional training in the care of sick and premature babies. […] One of the most important parts of care for premature babies is a medication called a corticosteroid. Research has found that giving the mother a steroid medication at least 48 hours prior to delivery greatly reduces the incidence and severity of respiratory disease in your baby. […] Care of premature babies may also include: Temperature-controlled beds, Monitoring of temperature, blood pressure, heart and breathing rates and oxygen levels, Giving extra oxygen by a mask or with a breathing machine, Mechanical ventilators (breathing machines) to do the work of breathing for your baby, Intravenous (IV) fluids – when feedings cannot be given, or for medications, Placement of catheters (small tube) into the umbilical cord to give fluids and medications and to draw blood, X-rays (for diagnosing problems and checking tube placement), Special feedings of breast milk or formula, sometimes with a tube into the stomach if a baby cannot suck, Medications and other treatments for complications, such as antibiotics, Kangaroo care – a method of caring for premature babies using skin-to-skin contact with the parent to provide contact and aid parent-infant attachment. […] The Center for Healthy Infant Lung Development provides comprehensive treatment to newborns, infants, and children with various forms of lung disease. […] The Neuroprotection and Neuroplasticity Program is working to find treatments for newborns at risk of brain injury.

• #3 Premature Infant: Causes, Complications, and More

  https://www.healthline.com/health/pregnancy/premature-infant

  Doctors often try to prevent a premature birth by giving the mother certain medications that can delay delivery. […] If premature labor cant be stopped or a baby needs to be delivered prematurely, doctors then prepare for a high-risk birth. The mother may need to go to a hospital that has a neonatal intensive care unit (NICU). This will ensure the infant receives immediate care after birth. […] In the first few days and weeks of the premature babys life, hospital care focuses on supporting vital organ development. The newborn may be kept in a temperature-controlled incubator. Monitoring equipment tracks the babys heart rate, breathing, and blood oxygen levels. It may be weeks or months before the baby is able to live without medical support. […] Many premature babies cant eat by mouth because they cant yet coordinate sucking and swallowing. These babies are fed vital nutrients either intravenously or using a tube inserted through the nose or mouth and into the stomach. Once the baby is strong enough to suck and swallow, breast-feeding or bottle-feeding is usually possible.

• #3 Pediatric Rehabilitation Therapy For Health Complications In Premature Babies | District Speech and Language Therapy | Speech Therapy Clinic in Washington DC

  https://districtspeech.com/pediatric-rehabilitation-therapy-for-health-complications-in-premature-babies/

  If your baby is born premature, pediatric physical therapy for premature babies can help promote growth and development. […] Early intervention tends to show better results than the wait and see approach. […] If your child does start to show signs of developmental issues due to being born premature, its important to see a speech therapist or physical therapist. […] Physical therapy can be very useful in treating cerebral palsy. […] The goal of physical therapy for cerebral palsy will be to improve the following areas: Strength, Balance, Posture, Coordination, Endurance, Pain management, Flexibility. […] A speech therapist may explore using bubbles, or the design drill to help provide treatment for your child’s speech disorder. […] Speech therapy can help with improvement in communication, as those with cerebral palsy may often have social communication disorders.

• #3 Treatment hope for premature babies – Hudson Institute of Medical Research

  https://www.hudson.org.au/news/treatment-hope-for-premature-babies/

  A treatment offering hope to parents of very premature babies is showing great promise, in the first worldwide stocktake of research into umbilical cord blood stem cells. […] Researchers from Hudson Institute of Medical Research have compiled the first comprehensive review of research using umbilical cord blood and cord-tissue stem cells to treat diseases in premature babies, and found their uses to be widespread and with evidence of benefit. […] According to lead author Dr Lindsay Zhou, umbilical cord blood and cord-tissue derived cells have been given to a total of 206 premature babies worldwide so far in 12 clinical trials. These trials show that cord blood and cord tissue cell treatments are safe for premature babies. […] They are being used to treat conditions in premature babies such as birth asphyxia, chronic lung disease of prematurity, congenital heart disease, and injuries to the preterm brain, Dr Zhou said.

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