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Clinical management of preterm delivery
1Department of Obstetrics & Gynecology, University of North Carolina, Chapel Hill 27599-7570.
The proper management of a patient in whom preterm delivery seems imminent includes the following. 1. Transfer of the patient to a tertiary perinatal hospital, if necessary and if safe 2. Prompt and skillful ultrasound examination for accurate estimation of fetal weight and gestational age 3. Consultation with the neonatologist regarding pharmacologic adjuvants to improve neonatal outcome 4. Meticulous intrapartum monitoring and physiologic support of the mother and her fetus during labor 5. Adequate pain relief and psychological support, with no specific form of analgesia or anesthesia being contraindicated simply because of preterm labor 6. The liberal but not universal use of cesarean delivery to avoid trapping of the fetal head in breech presentation (EFW less than 1,500 g) and to promptly deliver any fetus threatened by asphyxia 7. Skillful resuscitation of the newborn, especially those at the border of neonatal viability.
The proper management of a patient in whom preterm delivery seems imminent includes the following. 1. Transfer of the patient to a tertiary perinatal hospital, if necessary and if safe 2. Prompt and skillful ultrasound examination for accurate estimation of fetal weight and gestational age 3. Consultation with the neonatologist regarding pharmacologic adjuvants to improve neonatal outcome 4. Meticulous intrapartum monitoring and physiologic support of the mother and her fetus during labor 5. Adequate pain relief and psychological support, with no specific form of analgesia or anesthesia being contraindicated simply because of preterm labor 6. The liberal but not universal use of cesarean delivery to avoid trapping of the fetal head in breech presentation (EFW less than 1,500 g) and to promptly deliver any fetus threatened by asphyxia 7. Skillful resuscitation of the newborn, especially those at the border of neonatal viability.