[Preterm labor: timing and management].

Abstract

Premature rupture of membranes and intrauterine growth retardation are the most frequent conditions in which preterm labour and delivery may be facilitated or induced. If the membranes ruptured before 34 weeks, pregnancy may be prolonged for more than one week and premature fetus perhaps might benefit of steroid administration for the prevention of respiratory distress syndrome and of antibiotic preventive treatment. After 33 completed weeks no prolongation of gestation for more than one week seems to be particularly useful for newborn survival. Actually, intrauterine growth retardation and fetal chronic distress may be prematurely diagnosed (sonographic and Doppler diagnosis, non stress test, ecc.). Antepartum fetal evaluation and management of pregnancy with poor intrauterine growth are problems that need multidisciplinary measures, but the timing and the modality of delivery are strictly obstetric decisions. In case of fetal malformations and/or in case of extremely premature low-weight infants, management and timing of preterm labour and delivery need a particular care in observance of the well-being and of the outcome of these babies.