[The threat of premature labor: new aspects for management]

Genital inflammation may play a major role in the pathogenesis of preterm labor. Screening and early treatment of subclinical genital tract infections (bacterial vaginosis, heavy group B streptococci colonization, primary genital HSV infection and other silent intra-uterine infections) seem to offer promise for the prevention of preterm labor. New factors have been studied in order to appreciate their benefit in the evaluation of the risk of preterm labor. None of these biologic markers (fetal-fibronectin, maternal interleukin-6, vaginal pH measuring) have enough sensitivity to permit efficient screening. Home uterine activity monitoring seems to be interesting for early identification of women with increased risk of preterm delivery, but can't be used on a large scale because of its costs. New tocolytic agents are investigated in order to protect from an adverse outcome. Atosiban exhibits more oxytocin selective and antagonistic activity without side-effects, and nimesulide seems to have a lack of effects on fetal functions.