Pharmacological management of preterm delivery.

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Prematurity occurs when regular contractions begin to open your cervix before 37 weeks of pregnancy while a full-term pregnancy should last about 40 weeks. Both morbidity and mortality rates are inversely related to gestational age at delivery and each day of delay, particularly before 28 weeks of gestation, increases the survival.The available treatment options are symptomatic, rather than causally directed. Initially, preventive treatment with progesterone can lower the rate of PTL in high-risk groups significantly. Furthermore, between 24 and 33 weeks of gestation, the benefits of tocolytic therapy generally outweigh the risk of maternal, fetal, or both complications and these agents should be initiated provided no contraindications exist. A variety of tocolytic drugs with different mechanisms of action (betamimetics, oxytocin antagonists, calcium-channel blockers, nitric oxide donors, magnesium sulfate, and prostaglandin synthesis inhibitors) can be used for individualized tocolytic treatment. Furthermore, progesterones have proved the role in prolongation of gestation in PTL. Nevertheless, premature rupture of the membranes is an indication for antibiotics. Additionally, antenatal steroid administration could prevent respiratory distress syndrome in newborn effectively.