Authors

Carolina Sánchez-Cruzat Albertín

Position

Enfermera especialista en Obstetricia-Ginecología. Complejo Hospitalario de Navarra.

Contact address

Carolina Sánchez-Cruzat Albertín. C/ Puerta de Pamplona, 8, 4º A. 31621 Sarriguren (Navarra).

Contact email: carolinasc7@hotmail.com

Abstract

Objective: to gather the available scientific evidence about the care that have to be provided in a situation of threatened premature delivery (TPD).
Material and methods: literature review in the Cochrane Library, Pubmed and Cuiden databases. The search was limited to the period from 2000 to 2012 and documents in English, French and Spanish. Articles dealing with the etiology, diagnosis and treatment of TPD were included. The tag words used in the search were: “preterm delivery”, “tocolytics”, “diagnosis” and “treatment”.
Results: between 25-30% of preterm births were due to premature rupture of the membranes and 50% were considered idiopathic. Infections may play a causal role of ruptured membranes and preterm delivery. A positive biochemical test and a cervix measuring less than 25 mm cervix and/or a progressive decrease measurement of the cervix in two different scan examinations were useful predictors of TPD. A prophylactic cervical cerclage (between 17-27 weeks gestation) was indicated in cases of cervical incompetence. Progesterone was shown effective in risk pregnancies. Tocolytics (atosiban, the drug of excellence) showed prolongation of pregnancy up to seven days.
Conclusions: more than half of preterm births occur in pregnant women who have not been previously identified as high risk. Secondary prevention is carried out by means of diagnostic ultrasound of the cervix and biochemical markers. Prophylactic progesterone and cerclage are useful in the prevention of TPD. The nurse has a central role in the assessment of symptoms and follow-up of premature birth.

Keywords:

gynecology; mid-wife; Obstetrics; pre-term delivery; review; Threatened labor and delivery; tocolytics

Versión en Español

Título:

Amenaza de parto prematuro: una revisión bibliográfica