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Obstetric, neonatal and anesthetic considerations for preterm labor and delivery
Jonathan H Skerman1, Khalil E Rajab
1Department of Anesthesia and Intensive Care, College of Medicine and Medical Sciences, Arabian Gulf University, Intensive Care Unit, Salmaniya Medical Complex, Bahrain.
Insights
Preterm birth remains a significant obstetric challenge, causing most neonatal deaths. Despite decades of research, effective prevention strategies for preterm labor are lacking, highlighting a critical healthcare problem.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health
Background:
- Preterm birth is a major obstetric issue linked to significant perinatal mortality and long-term disabilities.
- Preterm births contribute substantially to neonatal deaths, accounting for 69-83% in various studies.
- The incidence of preterm birth has stagnated for decades, with limited advancements in its management.
Purpose of the Study:
- To highlight the persistent challenge of preterm birth in obstetrics.
- To underscore the lack of progress in preventing preterm labor despite its significant impact.
- To emphasize the need for novel strategies to address preterm birth incidence.
Main Methods:
- Review of existing literature on preterm birth incidence and management.
- Analysis of the contribution of preterm birth to neonatal mortality rates.
- Examination of the historical trends in preterm labor management strategies.
Main Results:
- Preterm birth is a leading cause of perinatal death and long-term handicap.
- The incidence of preterm birth has remained unchanged for over 30 years.
- Current management strategies for preterm labor have seen minimal evolution.
Conclusions:
- Efforts to prevent preterm birth have been largely unsuccessful to date.
- Preterm birth continues to be a critical healthcare problem globally.
- Improved management of very low birthweight infants has reduced perinatal mortality, not prevented preterm labor.
Abstract:
Preterm birth is a continuing obstetric problem that contributes significantly to the incidence of perinatal death and long-term handicap. In this context, various studies have shown preterm births account for between 69% and 83% of neonatal deaths. Despite this, the incidence of preterm birth has remained static for many years. One explanation for this is that the management of preterm labor has altered very little in the past 30 years. Strategies aimed at reducing the incidence of preterm birth include the identification of risk factors that increase the likelihood of preterm delivery. Treatment is then designed to target those risk factors and limit their effect. Although perinatal mortality has declined, mostly due to the improved management of very low birthweight babies rather than prevention of preterm labor, efforts to prevent preterm birth have been largely unsuccessful so far and preterm birth still represents a major health care problem to both developed and developing countries.