[Management of preterm labor]

Abstract

Objective: To define the management of preterm labor (MAP).

Method: The literature search was conducted using computer databases Medline and the Cochrane Library for a period from 1969 to March 2016.

Results: Leukocytosis screening may be useful in case of hospitalization for Preterm labor (PTL). Its use is not routine (professional consensus). Screening for urinary tract infection by urine culture should be systematic and antibiotic treatment should be performed in cases of bacterial colonization or urinary tract infection for a period of 7 days (grade A). The vaginal swab is useful to detect a strep B and was prescribed antibiotics during labor if positive (grade A). Routine antibiotic therapy is not recommended in case of PTL (grade A). Prolonged hospitalization does not reduce the risk of preterm delivery (NP3) and is not recommended (grade B). Bed rest does not reduce the risk of PTL (NP3), increases the risk of thromboembolism (NP3), and is not recommended (grade C). After hospitalization for PTL, a regular visit by a caregiver at home may be helpful when patients belong to a precarious environment or are psychologically vulnerable (Professional consensus). The benefit of monitoring home uterine activity repeated in the aftermath of hospitalization for PTL is not shown (NP3). It is not recommended to follow-up uterine activity systematically after hospitalization for PTL (grade C).

Conclusion: The management of PTL should be individualized, include searching and treatment of infection and avoid prolonged hospitalization or bed rest.

Keywords: Antibiothérapie; Antibiotics; Bed rest; CRP; Leucocytes; Leukocytes; Menace d’accouchement prématuré; Preterm labor; Repos au lit; Rest.