Threatened preterm birth

Definition

• Preterm birth is any birth before completion of 37+0 weeks.
• Very preterm means before 32+0 weeks, extremely preterm before 28+0 weeks.
• In Germany the preterm birth rate is about 8–9% of all pregnancies.
• Preterm birth is main cause of neonatal morbidity/mortality.

Aetiopathogenesis

Risk factors

• The strongest factor in the history is history of preterm birth or late miscarriage.
• Further factors are multiples, uterine anomalies, smoking.

Clinical features

More facts from the study questions

• Strict bed rest increases the risk of thrombosis in pregnancy.
• Urinary tract infections are a risk factor for preterm birth.
• The strongest anamnestic factor for preterm birth is a history of preterm birth or late miscarriage.
• Preterm birth is the most important cause of morbidity and mortality in neonates without malformations.
• The preterm birth rate in Germany is approximately 8 to 9 percent.
• Poor dental health with periodontitis is an often overlooked risk factor for preterm birth.
• The PROM test (Actim) detects IGFBP-1 (insulin-like growth factor-binding protein-1).
• The Partosure test (and AmniSure) detects PAMG-1.
• Partosure is a test for the detection of placental alpha-microglobulin-1 (PAMG-1).
• PAMG-1 is found in high concentrations in amniotic fluid.

Diagnosis

Three tests

• The fetal fibronectin (fFN) test detects fetal fibronectin in cervicovaginal fluid.
• PartoSure measures placental alpha microglobulin-1 (PAMG-1).
• The Actim PROM test rests on IGF-binding protein-1 (IGFBP-1).

Keep learning in the app

Further reading (selection)

1. StatPearls: Preterm Labor (NCBI Bookshelf)
2. DocCheck Flexikon, Frühgeburt

Cross-references