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02 February 2023, Volume 39 Issue 2 Previous Issue   

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Paying attention to understanding the high risk factors of preterm birth through inquiring about medical history at peripregnency and early pregnancy. SUN Wen, CHEN Dun-jin 2023, 39(2): 134-136.  DOI: 10.19538/j.fk2023020103 Abstract ( )   Preterm birth is a disease that seriously affects the outcome of perinatal infants.At present，the cause of the preterm birth is unclear.Most research data confirm that preterm labor has high risk factors，including the history of preterm labor，history of pregnancy with medical diseases，history of pregnancy complications，advanced pregnancy，low BMI，obese pregnant women，and malnutrition，etc.Identifing high-risk factors early is the key to preventing preterm birth.The key way to reduce the incidence of preterm labor is to identify high-risk factors by asking about medical history in the peripregnancy and early pregnancy.

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Argument about measurement of cervical length in middle pregnancy. CHEN Qian 2023, 39(2): 137-139.  DOI: 10.19538/j.fk2023020104 Abstract ( )   Preterm labor is the leading cause of neonatal severe short-term and long-term complications.Although some epidemiological high-risk factors are the main cause，preterm labor occurs in only 10% of women who deliver before 34 weeks of gestation.Whether it is singleton or twin pregnancy，the measurement of cervical length can be performed routinely by transvaginal ultrasonography at 18 to 24 weeks of gestation，and cervical length ≤25mm can be used an a cut-off value to predict preterm labor.

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Research progress in the prevention of preterm birth caused by cervical shortening with vaginal progesterone. LIU Yi-lin, LI Jia-po, QIAO Chong 2023, 39(2): 139-143.  DOI: 10.19538/j.fk2023020105 Abstract ( )   Cervical shortening means that the length of cervix is less than 25mm measured by vaginal ultrasound in the second trimester，which is of great significance for predicting spontaneous preterm birth and guiding clinical decision-making of threatened preterm birth.In recent years，many scholars start paying attention to high-risk factors，methods and the treatment strategies of cervical shortening.The review summarized the high-risk factors and mechanisms，indications，and clinical effects of progesterone，especially vaginal progesterone，in treating cervical shortening，in order to provide reference for the prevention and treatment of preterm birth.

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Indications and surgical methods of cervical cerclage for prevention of preterm birth. CHEN Han-qing, DENG Song-qing, WANG Zi-lian 2023, 39(2): 144-148.  DOI: 10.19538/j.fk2023020106 Abstract ( )   Cervical incompetence is an important cause of premature delivery.Although there is no unified standard for the diagnosis of cervical incompetence，cervical cerclage is an effective method to treat cervical incompetence.This article describes the diagnostic methods of cervical incompetence and the surgical indications and methods of cervical cerclage，aiming to provide clinical reference for the prevention of premature labor related to cervical incompetence.

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Problems related to emergency cervical cerclage to prevent preterm delivery. DAI Yi-min 2023, 39(2): 148-152.  DOI: 10.19538/j.fk2023020107 Abstract ( )   The aim of emergency cervical cerclage （ECC） is to prolong gestational weeks to avoid miscarriage in the third trimester or preterm delivery.  After exclusion of infection and active uterus contractions，for those women at 16-23+6 weeks，no more than 27+6 weeks，with singleton cervical ≥1cm，and/or membrane prolapse into vaginal intact membrane；twins cervical ≥1cm，ECC might be a safe and effective optiont. The key point of ECC procedure and the importance of standard management of the operation in ensuring clinical safety are also introduced.

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Research progress in clinical application of common tocolytic drugs. ZHOU Le, LIU Xing-hui 2023, 39(2): 153-157.  DOI: 10.19538/j.fk2023020108 Abstract ( )   In the treatment of threatened preterm labor，timely and effective application of tocolytic drugs is the most important treatment method.The commonly used tocolytic drugs in clinic include：β-adrenergic receptor agonists，calcium channel blockers，oxytocin receptor antagonists，prostaglandin synthetase inhibitors and magnesium sulfate.However，the effects and clinical characteristics of each tocolytic drugs are different.This article summarizes the research progress of several commonly used tocolytic drugs in the treatment of threatened preterm labor.

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Prevention of severe central nervous system complications in premature infants by magnesium sulfate：current situation. LIAN Yan, WANG Xie-tong 2023, 39(2): 157-160.  DOI: 10.19538/j.fk2023020109 Abstract ( )   Prenatal application of magnesium sulfate is recommended to protect fetal neural development and reduce cerebral palsy and the severity of cerebral palsy.The use of magnesium sulfate for fetal neuroprotection is recommended for pregnancies with high risk of preterm delivery within 24 hours，including premature rupture of membranes before full term，premature delivery with intact membranes，and planned preterm delivery due to fetal or maternal indications.Magnesium sulfate therapy should be started within 24 hours before delivery. Magnesium sulfate was infused intravenously within 20-30 min after initial loading of 4 g and maintained at 1 g/h until delivery or 24h.Repeated use of magnesium sulfate is not recommended currently because of limited data on the benefit of retreatment for unborn pregnancies after the initial course of treatment.If delivery is expected before 32 weeks of gestation，the use of magnesium sulfate reduces the severity and risk of cerebral palsy in surviving infants，regardless of the number of fetuses.If FGR is delivered at ＜ 32 weeks of gestation，magnesium sulfate should be used to protect the nerves of the fetus and newborn.

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Application strategy of antenatal corticosteroid at different gestational age. ZHOU Shu-wei, WANG Lan, QI Hong-bo 2023, 39(2): 160-165.  DOI: 10.19538/j.fk2023020110 Abstract ( )   The application of antenatal corticosteroid（ACS） can effectively reduce the morbidity and mortality of premature infants，and it is an important prenatal intervention to improve the prognosis of premature infants.The use of ACS should be based on the gestational age due to different fetal development and different responses to ACS.In this paper，the pharmacologic basis，clinical research evidence，controversy and guideline recommendation of ACS at different gestational age will be reviewed based on domestic and foreign literature and guidelines，hoping to provide reference for clinical practice.