Many of the above studies about preterm labor are disheartening. What should the obstetrician do for his/her patients? Dr. King points out that smoking and substance abuse should be discouraged, as these are both associated with preterm labor. Furthermore, attempts should be made to decrease the high-order multiple pregnancies, as this is a physician-induced (iatrogenic) cause of preterm labor. He says that physicians should be suspicious for preterm labor and that the diagnosis cannot be made over the phone. Because the treatment is not benign, obstetricians should be conservative in their diagnosis and treatment of preterm labor. If preterm labor is diagnosed, tocolytics can be given to patients to gain 48 hours in order to administer coriticosteroids. As stated above, the administration of corticosteroids is one of our greatest successes. The most recent ACOG Committee Opinion 273 shows that ACOG supports the use of a single course of steroids for women between 24 and 34 weeks' gestation who are at risk for preterm labor within 7 days. Finally, future studies on preterm labor will need to address the cascade of events that occur earlier in the preterm labor cycle.
David S. Cole, MD has no significant financial interests to disclose.
Medscape Ob/Gyn. 2002;7(1) © 2002 Medscape
Cite this: Highlights in Obstetrics From the 50th Annual Meeting of The American College of Obstetricians and Gynecologists - Medscape - Jun 12, 2002.