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Preterm Labor-

Preterm labor
* cause of precipitating factors of preterm birth
A. medical and obstetrical complication
1) placenta previa or abruption (50%)
2) amnionic fluid infection (38%)
3) immunological (e.g. antiphospholipid antibody syndrome) (30%)
4) cervical incompetence (16%)
5) uterine (e.g. anomaly, hydramnios, fibroids) (14%)
6) maternal-preeclampsia, drug intoxication (10%)
7) trauma or surgery (8%)
8) fetal anomalies (6%)
9) no cause (4%)
B. lifestyle factor
1) smoking
2) poor nutrition
3) poor weight gain during pregnancy
4) use of drug ? such as cocaine or alcohol
5) other maternal factors
low maternal age, poverty, short stature, occupational factor, psychological stress

1. ¿øÀÎ
(1) amnionic fluid infection
(2) bacterial vaginosis
2. ¿¹Ãø ¹× Áø´Ü
(1) À§Çèµµ ¿¹Ãø: Á¤È®ÇÑ ÀÓ½ÅÁÖ¼ö¸¦ ¾Ë¾Æ¾ß ºÐ¸¸ÀÇ ¿¹Èĸ¦ °áÁ¤ÇÒ ¼ö ÀÖ´Ù
(2) Áø´Ü: Áø´Ü±âÁØ
ÀӽŠ20~37ÁÖ¿¡ 5~8ºÐÀÇ ±ÔÄ¢ÀûÀÎ ÀڱüöÃàÀÌ ¹Ýº¹Çؼ­ ¿À°í
´ÙÀ½ Áß Çϳª ÀÌ»óÀÌ ³ªÅ¸³¯ ¶§
1) ÀڱðæºÎÀÇ ÁøÇ༺ º¯È­
2) Àڱà °æºÎ °³´ë°¡ 2cm ÀÌ»ó
3) cervical effacement°¡ 80%ÀÌ»ó
3. antepartum management
(1) óġ ¿øÄ¢
: ¾ç¸·ÆÄ¼ö°¡ ¾øÀ» ¶§ 35ÁÖ ÀÌÀü¿¡ ºÐ¸¸µÇ´Â °ÍÀ» ÇÇÇϵµ·Ï ÇÔ
(2) ¹æ¹ý
1) »êÀü steroid Åõ¿©: ÅÂ¾Æ Æó¼º¼÷ ÃËÁø
2) »êÀü phenobarbital°ú vitamin K Åõ¿©: ³ú½Ç³» ÃâÇ÷ °¨¼Ò
3) ÀڱðæºÎ ºÀÃà¹ý(cerclage): ÀÓ½Å37ÁÖ ÀÌÀü¿¡ ÀӽŠÁ¾°áµÈ »ê°ú·ÂÀÌ 3ȸ ÀÌ»óÀÎ °æ¿ì¿¡¸¸ ½ÃÇà
4) bacterial vaginosisÀÇ Ä¡·á
4. Á¶±â ÁøÅëÀ» ¾ïÁ¦ÇÏ´Â ¹æ¹ý
1) bed rest -1Â÷Àû
2) ¥â-adrenergic receptor agonists
3) magnesium sulfate
4) calcium channel blocking agents
* potential complications of tocolytic agent
A. beta-adrenergic agent
1. hyperglycemia 2. hypokalemia 3. hypotension 4. pulmonary edema
5. cardiac insufficiency 6. arrhythmia 7. myocardial ischemia 8. maternal death
B. magnesium sulfate
1. pulmonary edema 2. respiratory depression 3. cardiac arrest
4. maternal tetany 5. profound muscular paralysis 6. profound hypotension
C. indomethacin
1. hepatitis 2. renal failure 3. gastrointestinal bleeding
D. nifedipine
Transient hypotension
5. intrapartum management
(1) ÁøÅë½Ã óġ
1) Áö¼ÓÀûÀÎ ÀüÀÚÅÂ¾Æ °¨½Ã ÀåÄ¡¸¦ »ç¿ë
2) ½Å»ý¾ÆÀÇ Group B streptococcus °¨¿° ¿¹¹æ
(2) ºÐ¸¸ Áß Ã³Ä¡
1) ÃæºÐÇÑ È¸À½ Àý°³
2) ±â°üÁö »ð°ü°ú ÀΰøÈ¯±â¿ä¹ý µîÀÇ ÀÀ±Þóġ Áغñ¸¦ ¿Ïº®ÇÏ°Ô ÇÑ µÚ ½ÃÇà