Management of preterm labor and prevention of premature delivery.

Preterm births continue to be the leading cause of perinatal mortality despite efforts to prevent preterm labor. Tocolytic therapy with beta-mimetic drugs was believed to be the solution for preterm labor, but the Canadian Preterm Labor Investigators Group recently reported that the use of ritodrine had no significant beneficial effect. Despite the various methods presently used for the management of preterm labor and prevention of premature delivery, the incidence of preterm birth remains unchanged. Health professionals must remain optimistic, however, and continue to investigate causes, whether they are social or medical, and to seek the unknown. Nursing personnel should play an important role in this area as health promoters and educators of patients. Nurses should also collaborate with other health professionals to determine effectiveness of therapy and the causes of preterm labor. For instance, this author is currently involved in a research project seeking barriers to prenatal care using a questionnaire and reviewing maternal records in order to determine length of labor and its relationship to subsequent preterm labors. The goals of the Year 2000 National Health Objective for low birth weight and infant mortality are not likely to be attained. Prematurity has gained national attention, however, and with public and professional awareness, perhaps this problem will decrease.