Past obstetric history

Women at high risk of preterm labour will initially be detected based upon past obstetric history. (Table 21.4) Having had a single previous preterm delivery increases the risk of preterm delivery in a subsequent pregnancy four times when compared to a woman whose previous delivery was at term. Interestingly a past obstetric history which consists of a term delivery followed by a preterm delivery confers a higher risk of preterm delivery in the third pregnancy than a past obstetric history that consists of a preterm delivery followed by a term delivery. This may be because the latter group contains a disproportionate number of women whose preterm delivery was for 'non-recurring' causes such as placen-tal abruption, whereas in the former group some cases of preterm delivery following the term delivery may be

Table 21.4 Effect of past obstetric history upon relative risk of preterm delivery. Adapted from Hoffman HJ and Bakketeig LS. Clin Obstet Gynecol. (1984) 27(3): 539-52

First delivery

Second delivery

RR of PTL

Term

1

Preterm

4

Term

Term

0.5

Preterm

Term

1.3

Term

Preterm

2.5

Preterm

Preterm

6.5

due to damage to the cervix during the original term delivery.

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