During pregnancy, avoidance of risk factors such as smoking and alcohol consumption greatly reduces incidence of preterm labour. Knowledge of other common risk factors, such as medication related risk factors would significantly reduce the incidence of preterm labour. Attendance of the antenatal clinic where maternal education and early clinical intervention is done is another effective method. Mothers are educated on proper nutrition, avoiding stressful situations, hygiene and sanitation to reduce frequency and severity of maternal infections. 2.7 Management of preterm labour Clinical management of preterm labour is symptomatic rather than management of causal factors. However, many medical interventions to manage preterm labour do not result in plausible success. Use of progesterone, for example, to prevent preterm labour in high risk groups has about a 30% success rate (60). Referral of pregnant women to a health facility with capacity for adequate perinatal care in terms of medical equipment and specialised personnel does improve infant survival. Tocolysis is a common practice in local clinical setting. A variety of tocolytics with varied modes of action are employed. Commonly used are betamimetics such as salbutamol. Oxytocin antagonists, calcium channel blockers, nitrous oxide donors and prostaglandin synthesis inhibitors are also routinely used. Tocolysis, however, in as much as it affords longer latency and fewer births within 48 hours of administration to allow for steroid therapy, it does not improve perinatal mortality. In fact, it is associated with lower APGAR scores at 5 minutes in the newborn (61). 2.8 Identification of medication related risk factors for preterm labour In the prevention of any medical condition, it is important to identify the individuals who may be at an increased risk than others. In understanding the risk factors, an opportunity is availed to proactively develop strategies to reduce the occurrence of the problem. Medication related risk factors for preterm birth are best identified in the context of the population. This is so because medication use patterns differ from region to region and is affected by a multiplicity of factors. Health seeking behaviour also differs regionally affected by factors such as socio-economic indicators, accessibly and cultural practices. Use of alternative remedies, such as herbal medicines, and health services also follows a similar pattern.
During pregnancy, avoidance of risk factors such as smoking and alcohol consumption greatly reduces incidence of preterm labour. Knowledge of other common risk factors, such as medication related risk factors would significantly reduce the incidence of preterm labour. Attendance of the antenatal clinic where maternal education and early clinical intervention is done is another effective method. Mothers are educated on proper nutrition, avoiding stressful situations, hygiene and sanitation to reduce frequency and severity of maternal infections. 2.7 Management of preterm labour Clinical management of preterm labour is symptomatic rather than management of causal factors. However, many medical interventions to manage preterm labour do not result in plausible success. Use of progesterone, for example, to prevent preterm labour in high risk groups has about a 30% success rate (60). Referral of pregnant women to a health facility with capacity for adequate perinatal care in terms of medical equipment and specialised personnel does improve infant survival. Tocolysis is a common practice in local clinical setting. A variety of tocolytics with varied modes of action are employed. Commonly used are betamimetics such as salbutamol. Oxytocin antagonists, calcium channel blockers, nitrous oxide donors and prostaglandin synthesis inhibitors are also routinely used. Tocolysis, however, in as much as it affords longer latency and fewer births within 48 hours of administration to allow for steroid therapy, it does not improve perinatal mortality. In fact, it is associated with lower APGAR scores at 5 minutes in the newborn (61). 2.8 Identification of medication related risk factors for preterm labour In the prevention of any medical condition, it is important to identify the individuals who may be at an increased risk than others. In understanding the risk factors, an opportunity is availed to proactively develop strategies to reduce the occurrence of the problem. Medication related risk factors for preterm birth are best identified in the context of the population. This is so because medication use patterns differ from region to region and is affected by a multiplicity of factors. Health seeking behaviour also differs regionally affected by factors such as socio-economic indicators, accessibly and cultural practices. Use of alternative remedies, such as herbal medicines, and health services also follows a similar pattern.
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