Preterm labor resident survival guide: Difference between revisions
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==Causes== | ==Causes== | ||
===Common Causes=== | ===Common Causes=== | ||
* [[ | *[[Infection]]:So far, only [[intra-amniotic infection]] has been shown to cause preterm delivery. The other factors are being associated based on reports by clinical, [[epidemiologic]], placental [[Pathological|pathologic]], or experimental studies.[[Intra-amniotic infection|Intra-amniotic infections]] can be subclinical. One in four preterm [[infants]] are born due to this [[Causes|cause]].<ref name="pmid25124429">{{cite journal| author=Romero R, Dey SK, Fisher SJ| title=Preterm labor: one syndrome, many causes. | journal=Science | year= 2014 | volume= 345 | issue= 6198 | pages= 760-5 | pmid=25124429 | doi=10.1126/science.1251816 | pmc=4191866 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25124429 }} </ref> | ||
* [[ | **The most frequent route is the ascending pathway, but hematogenous dissemination can occur. | ||
* [[ | **[[Microorganisms]] are recognized by pattern recognition receptors, such as [[toll-like receptors]] (TLRs) | ||
* [[ | **[[TLR]]s stimulate the production of [[chemokines]] ([[IL-8]], [[C-C motif ligand 2]] (CCL2), etc.), [[cytokines]] ([[IL-1b]], [[TNF-a]], etc), [[prostaglandins]] and [[proteases]] which activate the quiescent [[myometrium]] and stimulates parturition.<ref name="pmid25124429">{{cite journal| author=Romero R, Dey SK, Fisher SJ| title=Preterm labor: one syndrome, many causes. | journal=Science | year= 2014 | volume= 345 | issue= 6198 | pages= 760-5 | pmid=25124429 | doi=10.1126/science.1251816 | pmc=4191866 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25124429 }} </ref> | ||
* [[ | **In 30% of cases of [[intra-amniotic infection]], [[bacteria]] can be found in the [[fetal circulation]] which causes [[fetal]] [[systemic inflammatory response]]. These fetuses are at risk for long-term [[complications]], such as [[cerebral palsy]] and [[chronic lung disease]], which emphasizes that these [[complications]] may not only occur due to immaturity but also [[inflammatory]] response.<ref name="pmid25124429">{{cite journal| author=Romero R, Dey SK, Fisher SJ| title=Preterm labor: one syndrome, many causes. | journal=Science | year= 2014 | volume= 345 | issue= 6198 | pages= 760-5 | pmid=25124429 | doi=10.1126/science.1251816 | pmc=4191866 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25124429 }} </ref> | ||
*[[Uterine ovedistension]] | |||
*[[Decidual senescence]] | |||
*[[Vascular disorders]] | |||
*[[Stress]] | |||
*[[Cervical disease]] | |||
*Decline in [[progesterone]] action | |||
*Breakdown in [[maternal]]-[[fetal]] tolerance. | |||
==Diagnosis== | ==Diagnosis== | ||
Revision as of 15:43, 1 April 2021
| Preterm labor Resident Survival Guide Microchapters |
|---|
| Overview |
| Causes |
| Diagnosis |
| Treatment |
| Dos |
| Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rinky Agnes Botleroo, M.B.B.S.
Synonyms and keywords:
Overview
Causes
Common Causes
- Infection:So far, only intra-amniotic infection has been shown to cause preterm delivery. The other factors are being associated based on reports by clinical, epidemiologic, placental pathologic, or experimental studies.Intra-amniotic infections can be subclinical. One in four preterm infants are born due to this cause.[1]
- The most frequent route is the ascending pathway, but hematogenous dissemination can occur.
- Microorganisms are recognized by pattern recognition receptors, such as toll-like receptors (TLRs)
- TLRs stimulate the production of chemokines (IL-8, C-C motif ligand 2 (CCL2), etc.), cytokines (IL-1b, TNF-a, etc), prostaglandins and proteases which activate the quiescent myometrium and stimulates parturition.[1]
- In 30% of cases of intra-amniotic infection, bacteria can be found in the fetal circulation which causes fetal systemic inflammatory response. These fetuses are at risk for long-term complications, such as cerebral palsy and chronic lung disease, which emphasizes that these complications may not only occur due to immaturity but also inflammatory response.[1]
- Uterine ovedistension
- Decidual senescence
- Vascular disorders
- Stress
- Cervical disease
- Decline in progesterone action
- Breakdown in maternal-fetal tolerance.
Diagnosis
Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ 1.0 1.1 1.2 Romero R, Dey SK, Fisher SJ (2014). "Preterm labor: one syndrome, many causes". Science. 345 (6198): 760–5. doi:10.1126/science.1251816. PMC 4191866. PMID 25124429.