Obstetrics

Preterm Labour and Birth

Preterm labour is suspected or established labour before 37 weeks; management aims to identify true imminent birth, gain safe time for corticosteroids, magnesium neuroprotection and in-utero transfer, and avoid delaying birth when infection, bleeding or fetal compromise makes delivery safer.

Definition

Preterm labour is suspected or established labour before 37+0 weeks. Established labour involves regular contractions with progressive cervical change. Preterm birth may occur with intact membranes or after preterm prelabour rupture of membranes and is a major cause of neonatal mortality and long-term morbidity.

First principles

Symptoms are not the same as established labour

Regular contractions, pelvic pressure or a show before 37 weeks require assessment, but preterm labour means progressive cervical change. With intact membranes at 30 weeks or more, transvaginal cervical length or fetal fibronectin can estimate the likelihood of birth within 48 hours; do not use both tests together.

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