The preterm parturition syndrome

By Roberto Romero, J. Espinoza, Juan Pedro Kusanovic, F. Gotsch, Sonia S. Hassan, O. Erez, T. Chaiworapongsa, M. Mazor. BJOG: an International Journal of Obstetrics and Gynaecology, 2006

1,374 citations recorded by the source corpus.

The implicit paradigm that has governed the study and clinical management of preterm labour is that term and preterm parturition are the same processes, except for the gestational age at which they occur. Indeed, both share a common pathway composed of uterine contractility, cervical dilatation and activation of the membranes/decidua. This review explores the concept that while term labour results from physiological activation of the components of the common pathway, preterm labour arises from pathological signalling and activation of one or more components of the common pathway of parturition. The term ‘great obstetrical syndromes’ has been coined to reframe the concept of obstetrical disease. Such syndromes are characterised by: (1) multiple aetiology; (2) long preclinical stage; (3) frequent fetal involvement; (4) clinical manifestations that are often adaptive in nature; and (5) gene–environment interactions that may predispose to the syndromes. This article reviews the evidence indicating that the pathological processes implicated in the preterm parturition syndrome include: (1) intrauterine infection/inflammation; (2) uterine ischaemia; (3) uterine overdistension; (4) abnormal allograft reaction; (5) allergy; (6) cervical insufficiency; and (7) hormonal disorders (progesterone related and corticotrophin‐releasing factor related). The implications of this conceptual framework for the prevention, diagnosis, and treatment of preterm labour are discussed.

Subfields: Epidemiology, Immunology, Public Health, Environmental and Occupational Health

View Paper: https://www.semanticscholar.org/paper/190f0a5d5e9bdd0f693e2874171db30fe51a6549

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In Epidemiology

1. Roberto Romero

In Immunology

1. Roberto Romero
2. P. Chaemsaithong

In Public Health, Environmental and Occupational Health

1. Roberto Romero
2. A. Agarwal
3. P. Chaemsaithong

Citations in the corpus

• The fetal inflammatory response syndrome. (2007, methodology): “Parts of this article have been previously published elsewhere.(9,272,273)”
• Acute Chorioamnionitis and Funisitis: Definition, Pathologic Features, and Clinical Significance (2015, methodology): “OCTOBER 2015 management, and treatment of FIRS.(56,143,350,351) Importantly, FIRS and SIRS can be caused by nonmicrobial-”
• THE “GREAT OBSTETRICAL SYNDROMES” ARE ASSOCIATED WITH DISORDERS OF DEEP PLACENTATION (2010, background): “ultiple etiologies include infection/inammation, ischemia due to vascular isease, cervical disease, uterine overdisension, abnormal allograft reaction, alergy, and endocrine disorders.(39) In a blinded cross-sectional study, Kim et al(7) determined the frequency of ontransformed spiral arteries in p”
• Inflammation and pregnancy: the role of the immune system at the implantation site (2011, background): “Parturition is characterized by an influx of immune cells into the myometrium in order to promote recrudescence of an inflammatory process [42,43].”
• Epidemiology and causes of preterm birth (2008, background): “68 Thus, bacterial infection probably predisposes to preterm birth.”
• The effects of oxidative stress on female reproduction: a review (2012, background): “These include uterine overdistension, ischemia, infection, cervical disease, endocrine disorders [237], decidual hemorrhage, and maternal-fetal activation of the hypothalamic-pituitary axis, amongst others [239].”