Diagnosis and Effective Management of Preterm Labor

Despite extensive research, we are still unable to diagnose, prevent and treat preterm labor. Monitoring efficacy of interventions that would allow this is largely biased by the inability to accurately identify true labor with the currently used crude technology. Progestin supplementation appears to be a promising approach to both preventing initiation of preterm labor and treating it once it is already established, given progesterone’s role in maintaining pregnancy as well as support from basic and clinical research. However, the questions on mechanisms of action, optimal progestin formulation, dose, route and timing of administration remain unanswered. We have established and reported noninvasive means to accurately monitor cervical ripening, by measuring collagen light-induced fluorescence (LIF) and myometrial contractility, by measuring uterine electromyo graphy (EMG). By accurately assessing the two components of parturition, cervical LIF and uterine EMG can help to identify effective prevention strategies and treatment of preterm labor.