Preterm birth: risk factors, identification and management

Preterm birth (PTB) is defined as birth before 37 completed weeks of gestation. Spontaneous preterm labour is the precursor of one third of all PTB, a further third following preterm premature rupture of membranes and the rest being medically indicated. Its incidence can vary depending on the geographical and demographic features of the population studied. The worldwide incidence of PTB ranges between 6 % and 15 %, but it is a percentage rapidly growing in relation to the fact that today some of those cases that in the past hesitated in second trimester ‘late’ abortions are included. The increase of this trend in industrialised countries is also strongly linked to the rise of maternal age and of the number of pregnancies following assisted reproductive treatments as well as to the introduction of new risk factors related to life style. The precise role of events linked to an increased risk of PTB is largely unknown, but decidual haemorrhage, mechanical factors, hormonal changes and cervicovaginal infections have been associated with the pathophysiology of PTB. It is nowadays important to investigate epidemiological and environmental factors to identify high-risk women.

This book draws on recently acquired knowledge to provide the reader with comprehensive, up-to-date information on the full range of obstetric complications that may be encountered during the third trimester of pregnancy and puerperium. For each complication, risk factors and clinical presentation are described and detailed guidance is provided on the appropriate treatment. The lucid text is complemented by a wealth of images, diagrams, flow charts, and drawings. The volume has been compiled in collaboration with a large group of gynecologists, obstetricians and internationally renowned scientists to provide an essential guide. Accordingly, the book is of interest to practitioners across the world, enabling them to deepen their knowledge and to refine their approach to complications in daily clinical practice.