Complication prevention

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::[***] ACOG recommends a woman with a singleton gestation and a prior spontaneous preterm singleton birth (<36w6d) should be offered progesterone supplementation starting at 16–24 weeks of gestation, regardless of transvaginal ultrasound cervical length, to reduce the risk of recurrent spontaneous preterm birth.
 
::[***] ACOG recommends a woman with a singleton gestation and a prior spontaneous preterm singleton birth (<36w6d) should be offered progesterone supplementation starting at 16–24 weeks of gestation, regardless of transvaginal ultrasound cervical length, to reduce the risk of recurrent spontaneous preterm birth.
   
::[***] Vaginal progesterone is recommended as a management option to reduce the risk of preterm birth in asymptomatic women with a singleton gestation without a prior preterm birth with an incidentally identified very short cervical length less than or equal to 20 mm before or at 24 weeks of gestation.
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::[***] Vaginal progesterone is recommended as a management option to reduce the risk of preterm birth in asymptomatic women with a singleton gestation without a prior preterm birth with an incidentally identified very short cervical length less than or equal to 25 (varies) mm before or at 24 weeks of gestation. Cont vaginal progesterone thru to 36weeks EGA.
 
   
  +
::[***] Vaginal progesterone is recommended as a management option to reduce the risk of preterm birth in asymptomatic women with a singleton gestation WITH a prior preterm birth with an identified very short cervical length less than or equal to 25 (varies) mm before or at 24 weeks of gestation. Cont vaginal progesterone thru to 36weeks EGA.
   
   

Latest revision as of 09:09, 11 October 2019


These should be addressed in most / all patients.

[edit] Prevention of Pre-Eclampsia

[***] USPSTF recommends the use of low-dose aspirin (81 mg/d) as preventive medication after 12 weeks of gestation in women who are at high risk for preeclampsia.


[edit] Prevention of Preterm Birth

[***] Screen for Asx. bacteruria & treat if positive.

[***] Smoking cessation

[***] Stop using illicit drugs

[***] Nutrition Review

[***] Universal cervical length screening is an option

[***] Discuss appropriate activity / occupational exertion


[***] See if they need cerclage / progesterone


SMFM Clinical Guildeline
[***] ACOG recommends a woman with a singleton gestation and a prior spontaneous preterm singleton birth (<36w6d) should be offered progesterone supplementation starting at 16–24 weeks of gestation, regardless of transvaginal ultrasound cervical length, to reduce the risk of recurrent spontaneous preterm birth.
[***] Vaginal progesterone is recommended as a management option to reduce the risk of preterm birth in asymptomatic women with a singleton gestation without a prior preterm birth with an incidentally identified very short cervical length less than or equal to 25 (varies) mm before or at 24 weeks of gestation. Cont vaginal progesterone thru to 36weeks EGA.
[***] Vaginal progesterone is recommended as a management option to reduce the risk of preterm birth in asymptomatic women with a singleton gestation WITH a prior preterm birth with an identified very short cervical length less than or equal to 25 (varies) mm before or at 24 weeks of gestation. Cont vaginal progesterone thru to 36weeks EGA.



[edit] References

Prevention of spontaneous preterm birth

ACOG Practice Bulletin on Prediction & Prevention of Preterm Birth

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