What is preterm labor?

"Regular uterine contractions were observed between 22 and 36 weeks of pregnancy,andIf there is progress in the degree of cervical dilation or effacement, or if the cervical dilation is 2cm or more at the initial examinationThis means there is a high risk of premature birth.

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It is known that the number of weeks of pregnancy at which preterm birth occurs is most closely related to perinatal outcomes such as neonatal death and cerebral palsy, and preventing preterm birth is one of the most important issues in perinatal medicine.To prevent preterm birth, drug therapy using tocolytic drugs for threatened preterm labor is widely used.However, the management of threatened preterm labor and the use of tocolytic drugs differ significantly between Europe and the United States and Japan.Evidence that the effectiveness of uterotonics in treating preterm labor is limited to 48 hoursTherefore, in Europe and the United States, a procedure known as short-term tocolysis is performed, in which tocolytic drugs are administered intravenously for a limited period of 48 hours to promote maturation of the baby. In Japan, on the other hand, long-term tocolysis is performed, in which tocolytic drugs are administered prophylactically even after uterine contractions have been suppressed in order to prevent recurrence, resulting in long-term hospitalization and management. However, there is no clear evidence that long-term tocolysis is effective in preventing premature birth or improving the prognosis of newborns, and there are many adverse effects associated with long-term treatment. In recent years, an increasing number of facilities in Japan are switching to short-term tocolysis as a management method,Compared to long-term tocolysis, there were no significant changes in mean age at delivery, preterm birth rate, or number of NICU admissions, and adverse events were reduced, it has been reported.

Therefore, at our hospitalPatients who have been diagnosed with threatened premature labor and are 26 weeks or older on or after November 1, 2019Regarding this, our basic policy is to perform short-term tocolysis (use of uterine contraction suppressants for 48 hours to 7 days).

Some people may be confused by the changes in treatment and management methods, but we appreciate your understanding.

Kitano Hospital Obstetrics and Gynecology Department