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New perspectives for the effective treatment of preterm labor

  • Marc J.N.C. Keirse
    Correspondence
    Reprint requests: Professor Marc J.N.C. Keirse, Department of Obstetrics and Gynecology, The Flinders University of South Australia, Flinders Medical Center, GPO Box 2100, Adelaide, South Australia 5001, Australia
    Affiliations
    Departments of Obstetrics and Gynecology, Leiden University Hospital, Leiden, The Netherlands

    Flinders Medical Center Adelaide, South Australia, Australia
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      Abstract

      Preterm birth (before 37 completed weeks of gestation) continues to account for the vast majority of neonatal morbidity and mortality. The incidence of preterm birth can be reduced by appropriate social interventions and antenatal care. Currently available tocolytic agents suffer from low uterospecificity and prolong pregnancy only marginally, although postponement of birth by a few days may be of some value. Further progress is needed in at least four areas: prevention of preterm labor; identification of preterm labor, selection of candidates for tocolysis, and treatment of preterm labor. Effective, early treatment of vaginosis offers particular promise for the prevention of preterm labor and identification of specific biochemical markers will facilitate early detection of this process. Oxytocin antagonists offer greater specificity than current tocolytics and can be expected to show improved efficacy and risk profiles. Such compounds will allow more effective treatment of preterm labor with a lower risk of side effects.

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