Obstetric management of preterm labour.

In recent years the trends in the obstetric management of preterm labour have moved in the direction of more active policies with greater use of fetal heart monitoring and Caesarean section to avoid traumatic and asphyxial damage to the baby. Conservative management still has an important place, especially in association with extreme prematurity. Following initial enthusiasm, the use of tocolytic drugs and antenatal corticosteroids are going through a phase of re-evaluation and careful assessment is essential in individual cases to avoid their inappropriate use. Future developments in the obstetric management of preterm labour will depend upon careful evaluation studies which examine not only the short-term mortality statistics but also the long-term effects in respect of neurological and developmental handicap. This task is one of the major challenges for obstetricians to tackle over the next two decades.