In the US preterm delivery affects approx. 1 in 10 births & is the cause of at least 75% of neonatal deaths, excluding conquental malformations The rate of fetal morbidity can be reduced w/the early & accurate diagnosis of preterm labor. Labor beginning between 20 - 37 weeks is preterm labor. A baby born at 24 weeks gestation has about a 50% chance of survival. * 26 weeks about 80% * 28 weeks about 91% For A baby born after 28 weeks & weighing more than 3lbs., the chances of survival are even further increased. After 32 weeks gestation a baby has a 96% chance of survival & a significant decrease in the chances of suffering significant health problems. What Happens if you go into preterm Labor? If a women is in preterm labor & has started to dilate magnesium sulfate is usually the first coarse of action, this is intravenous. It aids in the slowing or stopping of the contractions to stop labor & dilation. This is sometimes followed with another tocolytics drug like Turbutaline, Indomethecine, and Nifediphrine. These also aid in the uterus in slowing contractions. Next is cortisteroid treatment. This is usually betamethazone. It is given by injection. It is a steroid that aids in maturing the fetus lungs. This is given anytime around 24 weeks. There is also Fetal Fibronectin Testing. This is used to try to indicate preterm labor. It is a vaginal swab done to test fetal fibronectin, a protein produced by fetal membranes. This will help determine if labor is going to start within the next two weeks.
There usually are no reasons for preterm labor, but when there are reasons these are some. MATERNAL FACTORS - Low socioeconomic status - Non-white race - Maternal age, (younger than 18) or (older than 40) - Low pregnancy weight - Smoking -Substance Abuse MATERNAL HISTORY - Previous history of preterm delivery - Previous history of a second trimester abortion UTERINE FACTORS -Uterine volume increased -Uterine anomalies -Trauma INFECTION Progesterone Therapy Progesterone Therapy (17 alpha hydroxy progesterone caporate) 17P. A study done at University of North Carolina has found Progesterone to be very effective in treating preterm births. The injections reduced the risk of preterm birth before 37 weeks dropped by 34%. The risk of delivering earlier than 32 weeks dropped 42%. Other Progestational agents have had limited success in preventing premature birth, this is because these drugs are used to stop labor that has already started. 17Pis given by injection to prevent preterm labor from starting. The therapy starts from 16-20 weeks, and is given until 37 weeks. Right now certain pharmacies can make this serum & is starting to be used by maternal fatal specialists to treat patients that have a history of preterm delivery.
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