Band 101, Heft s2

Preconception care is an important aspect of pregnancy-related care. Unfortunately, it is often ignored or minimized by both the patient and the provider. This article provides a framework for preconception care by offering the mnemonic "VITAL MOM." It is hoped that this offering will assist the clinician in optimizing pregnancy outcome.

Diabetes mellitus is one of the most common medical complications of pregnancy. Two percent to 5% of pregnancies are complicated by diabetes, of which 90% are classified as gestational diabetes mellitus. Prevention of the fetal and maternal complications of diabetes presents unique challenges to all providers of healthcare to reproductive-aged diabetic women. The management of diabetes before, during, and after pregnancy can serve as a model of preventive healthcare. Preconception counseling and metabolic control before pregnancy reduce the rate of congenital malformations and the burden of suffering in offspring.

Preterm labor and delivery continues to be one of the most serious problems in obstetrics, both medically and socioeconomically. The more classically used definitions of preterm delivery may not be useful in this era of advances in neonatal care. Similarly, the classically used criteria for "success" in tocolysis may obscure benefits from prolongation of gestation that does not meet these criteria. This article reviews the etiologic theories, risk factors, diagnostic techniques, and possible primary and adjunctive modes of therapy for preterm labor. The emphasis of these recommendations is on their clinical utility for the practicing obstetric care provider.

Preterm birth is associated with significant neonatal mortality and morbidity nationwide. Multiple strategies have been used to attempt to reduce the incidence of preterm births, and none have been entirely successful. The current review contains assessment of recent literature and home uterine activity monitoring. It also makes some suggestions about how and when this diagnostic modality may be used in current obstetric practice.