Spontaneous preterm laborThe high risk factors include:Bad habits (such as smokingPreviouspretermdelivery≥10/day,alcoholism)Pregnancyinterval is shorterthan18Poverty and loweducation groupsmonthsorgreaterthan5yearsThreatened abortion in earlyPregnancy labor intensivepregnancyIntrauterineinfection (primarilyUUExcessive expansion ofthe uterusand Mycoplasmahominis(polyhydramnios,multiplepregnancyBacterial vaginosisPlacenta(placentaprevia,placentalabruption,placentadysfunction)Periodontal DiseaseCertain immunomodulatory geneabnormalityYEPT
Spontaneous preterm labor Previous preterm delivery Bad habits (such as smoking ≥10/day, alcoholism) Pregnancy interval is shorter than 18 months, or greater than 5 years Poverty and low education groups Threatened abortion in early pregnancy Pregnancy labor intensive Intrauterine infection (primarily UU and Mycoplasma hominis) Excessive expansion of the uterus (polyhydramnios, multiple pregnancy) Bacterial vaginosis Placenta (placenta previa, placental abruption, placenta dysfunction) Periodontal Disease Certain immunomodulatory gene abnormality
Pretermprematurelyrupturedmembranes.PPROMThe reasons and high risk factors include:BMl<19.8kg/m2PreviousPPROMMalnutritionSmokeCervical incompetenceUterinemalformations(suchasuterineseptum,singlehornoftheuterus,doubleuterus)IntrauterineinfectionBacterial vaginosisExcessiveexpansionoftheuterusAssisted reproductivetechnology
Preterm prematurely ruptured membranes, PPROM Previous PPROM BMI <19.8kg/m2 Malnutrition Smoke Cervical incompetence Uterine malformations (such as uterine septum, single horn of the uterus, double uterus) Intrauterine infection Bacterial vaginosis Excessive expansion of the uterus Assisted reproductive technology
Pretermbirth for medicalandobstetricalindications: Delivery for maternal or fetal indications in whichlabor is induced or the infant is delivered byprelabor cesarean delivery Preeclampsia, fetal distress, small for gestational ageand placental abruption werethe most commonindications for medical intervention resulting inpreterm birth.-Otherlesscommoncauseswerechronichypertension, placenta previa, unexplained bleedingdiabetes, renal disease, Rh isoimmunization, andcongenital malformations
Preterm birth for medical and obstetrical indications • Delivery for maternal or fetal indications in which labor is induced or the infant is delivered by prelabor cesarean delivery – Preeclampsia, fetal distress, small for gestational age, and placental abruption were the most common indications for medical intervention resulting in preterm birth. – Other less common causes were chronic hypertension, placenta previa, unexplained bleeding, diabetes, renal disease, Rh isoimmunization, and congenital malformations
Forecast: To those pregnancy women who have riskfactors for spontaneous preterm labor,after 24 weeks, we can periodic forecastshelping preterm birth risk assessment,timely processing: To those who feel unusually frequentcontractions after 20 weeks, we candetermine whether they need to usetocolytic by predicting, avoiding excessivemedication
Forecast • To those pregnancy women who have risk factors for spontaneous preterm labor, after 24 weeks, we can periodic forecasts, helping preterm birth risk assessment, timely processing. • To those who feel unusually frequent contractions after 20 weeks, we can determine whether they need to use tocolytic by predicting, avoiding excessive medication
Prediction of preterm deliveryTransvaginal ultrasoundexamination:- cervical length <25mm,- funnel formation with cervical shortening· Fetal fibronectin, fFN-fFN >50ng/ml is positiveIf fFN test negative-negative predictive value about no dilivery in 1weeks is 97%-negative predictive value about no dilivery in 2weeks is 95%
Prediction of preterm delivery • Transvaginal ultrasound examination: – cervical length <25mm, – funnel formation with cervical shortening • Fetal fibronectin, fFN – fFN >50ng/ml is positive – If fFN test negative – negative predictive value about no dilivery in 1 weeks is 97% – negative predictive value about no dilivery in 2 weeks is 95%