Preterm labor resident survival guide

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

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.

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