New perspectives for the effective treatment of preterm labor

Article Abstract:

Much research needs to be done to improve management of preterm labor. Preterm labor is defined as birth before 37 weeks gestation, although this spans a range of gestational ages and birth weights with widely variable prognoses. Better understanding of the causes of and risk factors for preterm labor as well as the physiology and biochemistry of labor in general could lead to better preventative measures and treatments for preterm labor. Reducing poverty could have greater effect than medical treatments. Improved means of detecting impending labor would be helpful as would safer, more effective drugs for suppressing labor. Nonetheless, advances are being made. Current labor-suppressing medications have limited effect, but they allow for evaluation of the fetus and treatment with drugs to mature the fetal lungs. Tests for detecting preliminary signs are becoming available, although their predictive value is low. New, more specific labor-suppressing drugs with fewer side effects are undergoing study. Treating vaginal infections may also be effective.

Management, Premature birth

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Randomized comparison of the effects of endocervical and vaginal prostaglandin E2 gel in women with various degrees of cervical ripeness

Article Abstract:

There appears to be little difference in delivery outcomes when using prostaglandin E2 to induce labor when the chemical is given vaginally or inside the cervix. Researchers randomized 288 women who were more than 37 weeks pregnant to receive prostaglandin E2 gel administered vaginally (140 women) or inside the cervix (142 women). If the women had not gone into labor after 6 hours, another dose was given. The only statistically significant difference between the groups was that the Bishop score was more likely to increase following the treatment in women who received prostaglandin E2 inside the cervix. Women who had had previous pregnancies were more likely to have a higher Bishop score after prostaglandin E2 administration regardless of how they received it. Almost half of the women receiving intracervical prostaglandin E2 went into labor after one dose, compared to 34% of those receiving the chemical vaginally.

Methods, Dosage and administration, Labor, Induced (Obstetrics), Induced labor, Prostaglandins E

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Prostanoid excretion in incipient singleton and twin pregnancies

Article Abstract:

Prostanoid production and excretion rise significantly in successful twin and singleton pregnancies. Researchers measured levels of prostanoid metabolites including prostacyclin and thromboxane A2 in urine from 23 women pregnant with either single or twin fetuses 20 weeks after embryo transfer. Levels of all prostanoids increased with pregnancy, with the ratio of prostacyclin to thromboxane A2 increasing for both single and twin pregnancies. Excretion of prostacyclin metabolites was higher in twin pregnancies than in singleton pregnancies. Prostanoids may help prepare the uterus for embryo implantation by promoting the development of blood vessels. Imbalances of prostacyclin and thromboxane A2 may cause miscarriage.

Measurement, Physiological aspects, Pregnancy, Prostanoids

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