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Ambulatory Management of Preterm Labor

RINCON, MONICA MD; PEREIRA, LEONARDO M. R. MD, MCR

Clinical Obstetrics & Gynecology: September 2012 - Volume 55 - Issue 3 - p 756–764
doi: 10.1097/GRF.0b013e31825c8b4b
Ambulatory Obstetric Care

The majority of patients with preterm labor will deliver at term, and universal treatment of preterm labor with tocolytics and antenatal corticosteroids results in widespread overtreatment while benefitting a minority of patients. Ambulatory strategies for preventing preterm birth and identifying at-risk patients are discussed. These include consideration of obstetric history, serial cervical length sonography, digital examination, and selective use of biomarker tests. Ambulatory therapies to reduce preterm birth include different formulations of progesterone and cerclage. Optimal use of antenatal corticosteroids is discussed, and a review of ambulatory management strategies for patients who are discharged home after tocolysis is conducted.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon

The authors declare that they have nothing to disclose.

Correspondence: Leonardo M. R. Pereira, MD, MCR, Department of Obstetrics & Gynecology, 3181 SW Sam Jackson Park Road, Oregon Health & Science University, Portland, OR 97239. E-mail: pereiral@ohsu.edu

© 2012 Lippincott Williams & Wilkins, Inc.