Abstract：
UNASSIGNED: Preterm labor (PTL) is one of the most common and serious pregnancy complications associated with significant perinatal morbidity and mortality, as well as long-term neurologic impairment in the offspring.
UNASSIGNED: The aim of this study was to review and compare the most recently published major guidelines on diagnosis, management, prediction, and prevention of this severe complication of pregnancy.
UNASSIGNED: A descriptive review of guidelines from the National Institute for Health and Care Excellence (NICE), the World Health Organization, the American College of Obstetricians and Gynecologists, the New South Wales Government, and the European Association of Perinatal Medicine (EAPM) on PTL was carried out.
UNASSIGNED: There is a consensus among the reviewed guidelines that the diagnosis of PTL is based on clinical criteria, physical examination, measurement of cervical length (CL) with transvaginal ultrasound (TVUS) and use of biomarkers, although there is disagreement on the first-line diagnostic test. The NICE and the EAPM are in favor of TVUS CL measurement, whereas the New South Wales Government mentions that fetal fibronectin testing is the mainstay for PTL diagnosis. Moreover, there is consistency among the guidelines regarding the importance of treating PTL up to 34 weeks of gestation, to delay delivery for 48 hours, for the administration of antenatal corticosteroids, magnesium sulfate, and in utero transfer to higher care facility, although several discrepancies exist regarding the tocolytic drugs of choice and the administration of corticosteroids and magnesium sulfate after 34 and 30 gestational weeks, respectively. Routine cesarean delivery in case of PTL is unanimously not recommended. Finally, the NICE, the American College of Obstetricians and Gynecologists, and the EAPM highlight the significance of screening for PTL by TVUS CL measurement between 16 and 24 weeks of gestation and suggest the use of either vaginal progesterone or cervical cerclage for the prevention of PTL, based on specific indications. Cervical pessary is not recommended as a preventive measure.
UNASSIGNED: Preterm labor is a significant contributor of perinatal morbidity and mortality with a substantial impact on health care systems. Thus, it seems of paramount importance to develop consistent international practice protocols for timely diagnosis and effective management of this major obstetric complication and subsequently improve pregnancy outcomes.
UNASSIGNED: The aim of this study was to review and compare the most recently published major guidelines on diagnosis, management, prediction, and prevention of this severe complication of pregnancy.
UNASSIGNED: A descriptive review of guidelines from the National Institute for Health and Care Excellence (NICE), the World Health Organization, the American College of Obstetricians and Gynecologists, the New South Wales Government, and the European Association of Perinatal Medicine (EAPM) on PTL was carried out.
UNASSIGNED: There is a consensus among the reviewed guidelines that the diagnosis of PTL is based on clinical criteria, physical examination, measurement of cervical length (CL) with transvaginal ultrasound (TVUS) and use of biomarkers, although there is disagreement on the first-line diagnostic test. The NICE and the EAPM are in favor of TVUS CL measurement, whereas the New South Wales Government mentions that fetal fibronectin testing is the mainstay for PTL diagnosis. Moreover, there is consistency among the guidelines regarding the importance of treating PTL up to 34 weeks of gestation, to delay delivery for 48 hours, for the administration of antenatal corticosteroids, magnesium sulfate, and in utero transfer to higher care facility, although several discrepancies exist regarding the tocolytic drugs of choice and the administration of corticosteroids and magnesium sulfate after 34 and 30 gestational weeks, respectively. Routine cesarean delivery in case of PTL is unanimously not recommended. Finally, the NICE, the American College of Obstetricians and Gynecologists, and the EAPM highlight the significance of screening for PTL by TVUS CL measurement between 16 and 24 weeks of gestation and suggest the use of either vaginal progesterone or cervical cerclage for the prevention of PTL, based on specific indications. Cervical pessary is not recommended as a preventive measure.
UNASSIGNED: Preterm labor is a significant contributor of perinatal morbidity and mortality with a substantial impact on health care systems. Thus, it seems of paramount importance to develop consistent international practice protocols for timely diagnosis and effective management of this major obstetric complication and subsequently improve pregnancy outcomes.
摘要：
未经证实：早产（PTL）是与围产期发病率和死亡率相关的最常见和最严重的妊娠并发症之一，以及后代的长期神经系统损害。
未经评估：本研究的目的是回顾和比较最近发表的主要诊断指南，管理,预测，和预防这种严重的妊娠并发症。
UNASSIGNED：对国家健康与护理卓越研究所（NICE）指南的描述性审查，世界卫生组织,美国妇产科学院，新南威尔士州政府,并对PTL进行了欧洲围产期医学协会（EAPM）。
UASSIGNED：在审查的指南中达成共识，PTL的诊断基于临床标准，体检,用阴道超声（TVUS）测量宫颈长度（CL）并使用生物标志物，尽管在一线诊断测试上存在分歧。NICE和EAPM支持TVUSCL测量，而新南威尔士州政府提到胎儿纤连蛋白检测是PTL诊断的主要手段.此外，关于治疗PTL至妊娠34周的重要性，指南之间存在一致性，延迟48小时交货，用于产前皮质类固醇的给药，硫酸镁,并在子宫内转移到更高的护理机构，尽管在34和30孕周后，关于选择的保胎药物以及皮质类固醇和硫酸镁的给药存在一些差异，分别。不建议在PTL的情况下进行常规剖宫产。最后,NICE,美国妇产科学院，EAPM强调了在妊娠16至24周之间通过TVUSCL测量筛查PTL的重要性，并建议使用阴道孕酮或宫颈环扎术预防PTL，根据具体的适应症。不建议将宫颈子宫托作为预防措施。
UNASSIGNED：早产是围产期发病率和死亡率的重要因素，对医疗保健系统产生重大影响。因此，对于及时诊断和有效治疗这一主要产科并发症,以及随后改善妊娠结局,制定一致的国际惯例方案似乎至关重要.
未经评估：本研究的目的是回顾和比较最近发表的主要诊断指南，管理,预测，和预防这种严重的妊娠并发症。
UNASSIGNED：对国家健康与护理卓越研究所（NICE）指南的描述性审查，世界卫生组织,美国妇产科学院，新南威尔士州政府,并对PTL进行了欧洲围产期医学协会（EAPM）。
UASSIGNED：在审查的指南中达成共识，PTL的诊断基于临床标准，体检,用阴道超声（TVUS）测量宫颈长度（CL）并使用生物标志物，尽管在一线诊断测试上存在分歧。NICE和EAPM支持TVUSCL测量，而新南威尔士州政府提到胎儿纤连蛋白检测是PTL诊断的主要手段.此外，关于治疗PTL至妊娠34周的重要性，指南之间存在一致性，延迟48小时交货，用于产前皮质类固醇的给药，硫酸镁,并在子宫内转移到更高的护理机构，尽管在34和30孕周后，关于选择的保胎药物以及皮质类固醇和硫酸镁的给药存在一些差异，分别。不建议在PTL的情况下进行常规剖宫产。最后,NICE,美国妇产科学院，EAPM强调了在妊娠16至24周之间通过TVUSCL测量筛查PTL的重要性，并建议使用阴道孕酮或宫颈环扎术预防PTL，根据具体的适应症。不建议将宫颈子宫托作为预防措施。
UNASSIGNED：早产是围产期发病率和死亡率的重要因素，对医疗保健系统产生重大影响。因此，对于及时诊断和有效治疗这一主要产科并发症,以及随后改善妊娠结局,制定一致的国际惯例方案似乎至关重要.
