By John C. Morrison
Preterm hard work is the commonest, catastrophic, and expensive problem of pregnancy. it's accountable for the majority of maternal antenatal sanatorium admissions and neonatal morbidity/mortality. This factor comprises state of the art details because it regards to plain method for diagnosing sufferers in danger for early supply in addition to an intensive clarification of the entire advances in tocolytic therapy of ladies who cross directly to boost preterm labor. whereas it truly is exhaustively referenced and scientifically supported, this knowledge will let the training clinician to take advantage of those on hand options in a pragmatic option to receive the superior effects for sufferers in danger for preterm supply.
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Extra resources for Preterm Labor: Prediction and Treatment (Obstetrics and Gynecology Clinics of North America, September 2005, Vol. 32, No. 3)
Am J Obstet Gynecol 2004;191:1063 – 9.  Korebrits C, Ramirez MM, Watson L, et al. Maternal corticotrophin-releasing hormone is increased with impending preterm birth. J Clin Endocrinol Metab 1998;83:1585 – 91.  Bisits A, Madsen G, McLean M, et al. Corticotropin-releasing hormone: a biochemical predictor of preterm delivery in a pilot randomized trial of the treatment of preterm labor. Am J Obstet Gynecol 1998;178:862 – 6.  Warren WW, Patrick SL, Goland RS. Elevated maternal plasma corticotropin-releasing hormone levels in pregnancies complicated by preterm labor.
In women who delivered term and preterm, a gradual rise was noted in the highest weekly salivary estriol value. Consistent with prior studies was the observation of a surge in salivary estriol levels 3 weeks before delivery, whether the delivery was term or preterm. The investigators also noted that women with a resultant preterm delivery, when compared with those who delivered at term, consistently had higher weekly estriol levels between 24 and 34 weeks. 3 ng/mL as the optimal cutoff for predicting those women at risk for preterm labor and delivery, with a sensitivity of 71%, specificity of 77%, and positive predictive value of 23%.
Br J Obstet Gynaecol 1987;94:227 – 35.  Moran DJ, McGarrigle HH, Lachelin GC. Lack of normal increase in saliva estriol/progesterone ratio in women with labor induced at 42 weeks’ gestation. Am J Obstet Gynecol 1992;167: 1563 – 4.  Vining RF, McGinley R, Rice BV. Saliva estriol measurements: an alternative to the assay of serum unconjugated estriol assessing feto-placental function. J Clin Endocrinol Metab 1983; 56:454 – 60.  Voss HF. Saliva as a fluid for measurement of estriol levels.