Table Of ContentPreterm Birth
Prevention and Management
Preterm Birth: Prevention and Management Edited by Vincenzo Berghella
© 2010 Blackwell Publishing Ltd. ISBN: 978-1-405-19290-3
To all pregnant women and their babies
Preterm Birth
Prevention and Management
EDITED BY
Vincenzo Berghella
Director, Maternal-Fetal Medicine;
Professor, Obstetrics and Gynecology,
Thomas Jefferson University,
Philadelphia
USA
A John Wiley & Sons, Ltd., Publication
This edition fi rst published 2010, © 2010 by Blackwell Publishing Ltd
Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing
program has been merged with Wiley’s global Scientifi c, Technical and Medical business to form
Wiley-Blackwell.
Registered offi ce: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex,
PO19 8SQ, UK
Editorial offi ces: 9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA
For details of our global editorial offi ces, for customer services and for information about how to
apply for permission to reuse the copyright material in this book please see our website at www.
wiley.com/wiley-blackwell
The right of the author to be identifi ed as the author of this work has been asserted in accordance
with the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or
otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the
prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in
print may not be available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All
brand names and product names used in this book are trade names, service marks, trademarks or
registered trademarks of their respective owners. The publisher is not associated with any product
or vendor mentioned in this book. This publication is designed to provide accurate and
authoritative information in regard to the subject matter covered. It is sold on the understanding
that the publisher is not engaged in rendering professional services. If professional advice or other
expert assistance is required, the services of a competent professional should be sought.
The contents of this work are intended to further general scientifi c research, understanding, and
discussion only and are not intended and should not be relied upon as recommending or
promoting a specifi c method, diagnosis, or treatment by physicians for any particular patient. The
publisher and the author make no representations or warranties with respect to the accuracy or
completeness of the contents of this work and specifi cally disclaim all warranties, including
without limitation any implied warranties of fi tness for a particular purpose. In view of ongoing
research, equipment modifi cations, changes in governmental regulations, and the constant fl ow of
information relating to the use of medicines, equipment, and devices, the reader is urged to
review and evaluate the information provided in the package insert or instructions for each
medicine, equipment, or device for, among other things, any changes in the instructions or
indication of usage and for added warnings and precautions. Readers should consult with a
specialist where appropriate. The fact that an organization or Website is referred to in this work as
a citation and/or a potential source of further information does not mean that the author or the
publisher endorses the information the organization or Website may provide or recommendations
it may make. Further, readers should be aware that Internet Websites listed in this work may
have changed or disappeared between when this work was written and when it is read. No
warranty may be created or extended by any promotional statements for this work. Neither the
publisher nor the author shall be liable for any damages arising herefrom.
Library of Congress Cataloging-in-Publication Data
Preterm birth : prevention and management / [edited by] Vincenzo Berghella.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4051-9290-3
1. Premature labor. I. Berghella, Vincenzo.
[DNLM: 1. Premature Birth–prevention & control. WQ 330 P91965 2010]
RG649.P 747 2010
618.3′97–dc22
2009030110
ISBN: 978-1-4051-9290-3
A catalogue record for this book is available from the British Library.
Set in 9.5 on 13 pt Meridien by Toppan Best-set Premedia Limited
Printed and bound Singapore
1 2010
Contents
List of Contributors, vii
Defi nitions, xi
Abbreviations, xii
Preface, xiii
1 The Global Impact of Preterm Birth, 1
Jennifer Harris Requejo & Mario Merialdi
2 Preterm Birth: A Complex Disease, 8
Eric J. Hodgson & Charles J. Lockwood
3 Why Prevention?, 17
Jason K. Baxter
4 The Epidemiology of Preterm Birth, 22
Robert L. Goldenberg & Elizabeth M. McClure
5 Genetics of Preterm Birth, 39
Heidi L. Thorson & Hyagriv N. Simhan
6 The Cervix, 50
Vincenzo Berghella
7 Infl ammation and Infection, 57
Roberto Romero, Francesca Gotsch, Shali Mazaki-Tovi &
Juan Pedro Kusanovic
8 The Endocrine Regulation of Human Labor, 78
Roger Smith, Julia I. Smith & Andrew M. Bisits
9 Preventive Issues for All Gravidas, 88
Priyadarshini Koduri
10 Tobacco and Preterm Birth, 102
Jeroen P. Vanderhoeven & Jorge E. Tolosa
11 Care for Women with Prior Preterm Birth, 115
Jay D. Iams
v
vi Contents
12 Short Cervical Length, 130
Timothy J. Rafael
13 Fetal Fibronectin, 149
Maria Bisulli
14 Bacterial Vaginosis, 161
Nancy W. Hendrix
15 Sexually Transmitted Infections, 171
Neil S. Seligman
16 Multiple Gestations: Preventing and Managing Preterm Birth, 183
Edward J. Hayes & Suneet P. Chauhan
17 Asymptomatic Manual Cervical Changes, 190
Leonardo Pereira
18 Preterm Labor, 198
Amen Ness, Yair Blumenfeld & Joyce F. Sung
19 Preterm Premature Rupture of the Membranes, 217
Brian M. Mercer
20 Promotion of Fetal Maturation, 232
Kellie E. Murphy
21 Location, Mode of Delivery and Intrapartum Issues for the Preterm
Gestation, 242
Dana Figueroa & Dwight J. Rouse
22 Perinatal Care and Long-Term Implications, 252
Janet E. Larson, Shobhana A. Desai & William McNett
23 Ethical Issues Related to Preterm Birth, 262
Frank A. Chervenak & Laurence B. McCullough
24 Future Research, 270
Catherine Y. Spong
Index, 275
List of Contributors
Jason K. Baxter MD, MSCP
Director, Division of Research; Assistant Professor, Division of Maternal- Fetal Medicine,
Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, USA.
Vincenzo Berghella MD, FACOG
Director, Division of Maternal- Fetal Medicine; Director, Maternal- Fetal Medicine Fellowship
Program; Professor, Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, USA.
Andrew M. Bisits MBBS, FRANZCOG, MMedStats
Director of Obstetrics, Acting Clinical Director, Division of Obstetrics and Gynaecology, John
Hunter Hospital, NSW, Australia.
Maria Bisulli MD
Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital, University of Bologna,
Bologna, Italy
Yair Blumenfeld MD
Clinical Assistant Professor, Division of Maternal- Fetal Medicine, Department of Obstetrics and
Gynecology, Stanford University Medical Center, California, USA.
Suneet P. Chauhan MD
Aurora Sinai Medical Center, Milwaukee, Wisconsin, USA.
Frank A. Chervenak MD, MMM
Given Foundation Professor and Chairman, Department of Obstetrics and Gynecology, Weill
Cornell Medical College, New York Presbyterian Hospital, New York, USA.
Shobhna A. Desai MD
Clinical Associate Professor of Pediatrics, Director, Children’ s Rehabilitation Unit, Director, Special
Banies ’ Follow up Program, Division of Neonatology, Nemours Pediatrics, Thomas Jefferson
University, Philadelphia, USA.
Dana Figueroa MD
Fellow and Clinical Instructor, Division of Maternal- Fetal Medicine, and Center for Women’ s
Reproductive Health, The University of Alabama at Birmingham, Alabama, USA.
Robert L. Goldenberg MD
Professor, Department of Obstetrics and Gynecology, Drexel University College of Medicine,
Philadelphia, USA.
vii
viii List of Contributors
Francesca Gotsch MD
Visiting Fellow, Perinatology Research Branch, E unice Kennedy Shriver National Institute to Child
Health and Human Development, National Institutes of Health, Michigan, USA.
Edward J. Hayes MD, MSCP
Perinatologist, Division of Maternal- Fetal Medicine, The Women’ s Center at Aurora Bay Care
Medical Center, Wisconsin, USA.
Nancy W. Hendrix MD
Fellow, Division of Maternal- Fetal Medicine; Clinical Instructor, Department of Obstetrics and
Gynecology, Thomas Jefferson University, Philadelphia, USA.
Eric J. Hodgson MD
Clinical Instructor and Fellow, Division of Maternal- Fetal Medicine, Department of Obstetrics,
Gynecology and Reproductive Sciences, Yale University School of Medicine, Connecticut, USA.
Jay D. Iams MD
Frederick P. Zuspan Professor and Endowed Chair, Division of Maternal- Fetal Medicine,
Department of Obstetrics and Gynecology, The Ohio State University Medical Center, Ohio, USA.
Priyadarshini Koduri MD
Fellow, Division of Maternal- Fetal Medicine; Clinical Instructor, Department of Obstetrics and
Gynecology, Thomas Jefferson University, Philadelphia, USA.
Juan Pedro Kusanovic MD
Assistant Professor, Department of Obstetrics and Gynecology, Wayne State University,
Perinatology Research Branch, E unice Kennedy Shriver National Institute of Child Health and
Human Development, National Institutes of Health, Michigan, USA.
Janet E. Larson MD
Chief, Division of Neonatology, Nemours Pediatrics, Thomas Jefferson University, Philadelphia,
USA.
Charles J. Lockwood MD
The Anita O ’ Keefe Young Professor of Women’ s Health and Chair, Department of Obstetrics,
Gynecology and Reproductive Sciences, Yale University School of Medicine, Connecticut, USA.
Shali Mazaki - Tovi MD
Fellow, Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, Wayne
State University, Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Michigan, USA.
Elizabeth M. McClure MEd.
Department of Epidemiology, University of North Carolina School of Public Health, and
Department of Statistics and Epidemiology, Research Triangle Institute, North Carolina, USA.
Laurence B. McCullough PhD
Dalton Tomlin Chair in Medical Ethics and Health Policy, Center for Medical Ethics and Health
Policy, Baylor College of Medicine, Texas, USA.
William McNett MD
Associate Professor, Pediatrics; Division Chief, Department of Pediatrics, Nemours Pediatrics,
Thomas Jefferson University, Philadelphia, USA.
Mario Merialdi MD, PhD, MPH
Coordinator, Improving Maternal and Perinatal Health (MPH), Department of Reproductive
Health and Research, World Health Organization, Geneva, Switzerland.
List of Contributors ix
Brian M. Mercer MD, FRCSC, FACOG
Professor, Reproductive Biology, Case Western Reserve University; Vice- Chair, Director of
Obstetrics and Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, MetroHealth
Medical Center, Ohio, USA.
Kellie E. Murphy MD, MSc, FACOG, FRCSC
Associate Professor, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada.
Amen Ness MD, MSCP
Clinical Assistant Professor, Division of Maternal- Fetal Medicine, Department of Obstetrics and
Gynecology, Stanford University Medical Center, California, USA.
Leonardo Pereira MD, MCR
Assistant Professor, Director Division of Maternal- Fetal Medicine, Oregon Health and Science
University, Oregon, USA.
Timothy J. Rafael MD
Fellow, Division of Maternal- Fetal Medicine; Clinical Instructor, Department of Obstetrics and
Gynecology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, USA.
Jennifer Harris Requejo PhD, MA, MHS
Assistant Scientist, Institute for International Programs, Johns Hopkins Bloomberg School of Public
Health, Maryland, USA; Technical Consultant, Partnership for Maternal, Newborn and Child
Health and Department of Reproductive Health and Research, World Health Organization,
Geneva, Switzerland.
Roberto Romero MD
Chief, Perinatology Research Branch, Eunice Kennedy Shriver National Institute to Child Health and
Human Development, National Institutes of Health; Program Director of Obstetrics and
Perinatology, Intramural Division, NICHD, NIH, DHHS; Professor of Molecular Obstetrics and
Genetics, Center for Molecular Medicine and Genetics, Wayne State University; Professor of
Epidemiology, Michigan State University. Wayne State University/Hutzel Women’ s Hospital,
Michigan, USA.
Dwight J. Rouse MD, MSPH
Professor, Director, Center for Women’ s Reproductive Health, The University of Alabama at
Birmingham, Alabama, USA.
Neil S. Seligman MD
Fellow, Division of Maternal- Fetal Medicine; Clinical Instructor, Department of Obstetrics and
Gynecology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, USA.
Hyagriv N. Simhan, MD, MSCR
Associate Professor and Chief, Division of Maternal- Fetal Medicine, Department of Obstetrics,
Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh,
USA.
Julia I. Smith BSc (Hons), MMedStats
Biostatistician, Mothers and Babies Research Centre, University of Newcastle, NSW, Australia.
Roger Smith MB, BS (Hons), PhD
Director, Mothers and Babies Research Centre and Endocrine Unit, John Hunter Faculty of
Health/School of Medicine and Public Health, University of Newcastle, NSW, Australia.
Catherine Y. Spong MD
Chief, Pregnancy and Perinatology Branch, Eunice Kennedy Shriver National Institute of Child
Health and Human Development, National Institutes of Health, Maryland, USA.
x List of Contributors
Joyce F. Sung MD
Fellow, Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, Stanford
University Medical Center, California, USA.
Heidi L. Thorson MD
Fellow and Clinical Instructor in Maternal- Fetal Medicine and Medical Genetics, Department of
Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine,
Pittsburgh, USA.
Jorge E. Tolosa MD, MSCE
Associate Professor of Obstetrics and Gynecology, Division of Maternal- Fetal Medicine,
Department of Obstetrics and Gynecology, Oregon Health and Science University, Oregon, USA.
Jeroen P. Vanderhoeven MD
Department of Obstetrics and Gynecology, Oregon Health and Sciences University, Oregon, USA.
