Predicting Preterm Labour: Current Status and Future Prospects

Abstract

Preterm labour and birth are a major cause of perinatal morbidity and mortality. Despite modern advances in obstetric and neonatal management, the rate of preterm birth in the developed world is increasing. Yet even though numerous risk factors associated with preterm birth have been identified, the ability to accurately predict when labour will occur remains elusive, whether it is at a term or preterm gestation. In the latter case, this is likely due to the multifactorial aetiology of preterm labour wherein women may display different clinical presentations that lead to preterm birth. The discovery of novel biomarkers that could reliably identify women who will subsequently deliver preterm may allow for timely medical intervention and targeted therapeutic treatments aimed at improving maternal and fetal outcomes. Various body fluids including amniotic fluid, urine, saliva, blood (serum/plasma), and cervicovaginal fluid all provide a rich protein source of putative biochemical markers that may be causative or reflective of the various pathophysiological disorders of pregnancy, including preterm labour. This short review will highlight recent advances in the field of biomarker discovery and the utility of single and multiple biomarkers for the prediction of preterm birth in the absence of intra-amniotic infection.

Diagnostic Accuracy of PremaQuick versus Actim Partus in Prediction of Preterm Labor in Symptomatic Women within 14 Days

“…In order to institute specific therapy more appropriately, it is important to Open Journal of Obstetrics and Gynecology have an accurate and reliable biomarker predictive test(s) to predict women at risk of PTL than currently available tests [9]. Actim-Partus is a bedside immuno-enzymatic test relying on the monoclonal antibodies specific for phIGFBP1 [17].…”

“…Unlike the amniotic fluid, the CVF is easily accessible and its collection is minimally invasive. There are two cervico-vaginal biomarkers used for the prediction of PTL: fFN and phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) [9]. fFN has poor PPV for detection of PTL and used mainly in detection of PTL due to its high NPV [10] [11].…”

Prediction of risk of preterm delivery by cervical assessment by trans-vaginal ultrasound

“…2,4 Seeing to the complications of preterm births it is desirable to take measures to prevent preterm delivery if possible or to refer women with risk of preterm delivery to centres with well-equipped neonatal care units. 5 Several methods like home uterine monitoring, cervical examination, fetal fibronectin in cervico-vaginal secretions etc. have been used for identifying women at risk of preterm delivery.…”

The preliminary clinical observation and analysis of childbearingage women with a history of iodine-131 treatment for Graves' disease

“…Because an increased risk of miscarriage, fetal or neonatal death is correlated with higher maternal TSH levels in pregnancy (14), the mothers' serum TSH levels should be manipulated to lower levels before they become pregnant. After iodine-131 treatment, 50 women patients were subclinically hypothyroid, and they needed L-T4 to control TSH and circulating thyroid hormones to maintain normal thyroid function.…”