Diagnosis of preterm labor

The obvious means by which one can make the diagnosis of preterm birth, namely preterm delivery, is not satisfactory if we are to optimize outcome of pregnancy. However, the indiscriminate use of drugs to inhibit questionable preterm labor is also not desirable. There is a pressing need for an improved method of diagnosis. If some biochemical means were available to diagnose preterm labor, the short-term use of tocolytic therapy (until the result of the testing procedure was known) would be indicated in questionable cases of preterm labor. Until such time that improved methods of diagnosis are available, it would seem preferable to err on the side of overdiagnosis, particularly in very early preterm labor where neonatal morbidity and mortality are excessively high.