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Research Article| Volume 9, ISSUE 3, P153-157, September 1999

Recent advances in the prediction of preterm labour

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      Abstract

      The sequence of biochemical events that lead to the initiation of human parturition at term are not understood, but there is even less understanding of the events that lead to the initiation of preterm labour. Presumably, it this lack of understanding of the underlying pathogenesis that has hampered progress, until recently, in the area of prediction of preterm labour. Various methods of predicting preterm labour have been studied. Home uterine activity monitoring has recently been shown to be of limited use, while risk scoring systems perform poorly in practice. Transvaginal ultrasound assessment of the cervix has a role to play in the prediction of preterm labour. The presence of fetal fibronectin in cervicovaginal fluid in the late second and early third trimesters is an important risk factor for preterm labour. The measurement of concentrations of certain pro-inflammatory cytokines in cervicovaginal secretions at similar gestations may also prove to be clinically useful. Additional potential biochemical markers are the subject of ongoing research. The ability to predict preterm labour will improve as knowledge of the pathophysiologies underlying preterm labour increases.
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