Ep 37: Prediction and Prevention of Preterm Labor

Practice Bulletin #130 - Published October 2012 (Reaffirmed 2018)



Five pearls:

1.  Spontaneous preterm birth rates are decreasing with time (woohoo!)

2.  Good thing, because PTD at <34 wga carries higher mortality and morbidity risk to the newborn at time of delivery as well as long-term morbidity



3.  In pregnant patients with a history of PTD, 17-OH-P supplementation should be recommended at 16-24 wga and continued through 36 wga

4.  In patients w/ singleton pregnancy and history of PTD, cerclage should be offered if CL <25 mm is detected on TVUS at <24 wga



5.  In patients without a history of PTD, finding incidental CL of <20 mm at <24 wga may suggest benefit from vaginal progesterone supplementation





Shout-outs:

- Felicia Sokol, doula (on Instagram)

- Maryn Green, CPM (her podcast, on Twitter, Instagram)

- Rebecca Dekker, PhD (her website, on Twitter, Instagram)

- Esther Perel (her podcast, on Twitter, Instagram)

- Michael Fratkin, MD (on Twitter)

- End Well Project (website, on Twitter, Instagram)



SHOW NOTES



This episode pairs nicely with the 2018 Cabernet Sauvignon from 19Crimes. Main theme music by my main amigo, Evan Handyside