EC Gynaecology

Preterm birth (PTB) is a significant concern in obstetric care, affecting about 11% of all live births. It contributes significantly to perinatal morbidity, mortality, and long-term impairment (second to pneumonia). PTB can be prevented using a multimodal strategy, including public health initiatives, lifestyle changes, improved access to obstetric care, accurate prediction and diagnostic techniques, and efficient and focused therapies. Some areas have progressed, while others remain fraught with dispute and ambiguity. Primary prevention, involving patient education, smoking cessation, improvement in nutritional status, and avoidance of late preterm deliveries, has limitations. Secondary prevention concentrates on avoiding repeated PTBs, the most common risk factor.

A pessary or progesterone can prevent PTB in single or multiple pregnancies with a short cervix and no prior PTB. Cervical cerclage treats structural flaws or cervical weakness in high-risk women with a short cervix. Corticosteroids are the only antenatal intervention that improves post-delivery neonatal outcomes. They may also reduce newborn mortality, cerebral hemorrhage, and neonatal infection. Tocolytics, particularly calcium channel blockers and prostaglandin inhibitors, may provide the time required to deliver antenatal corticosteroids and, if necessary, transfer to a tertiary care institution. This study provides a holistic review of the history, consequences, differential diagnosis, sequelae, treatment, and prevention of PTB.

Keywords: Congenital Disorders; Perinatal Morbidity; Pessary; Prostaglandin Inhibitor; Smoking Cessation

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