Kazuo Maeda*
Aims: To clarify the feasibility to arrest preterm labor to prevent the periventricular leukomalacia (PVL) and Cerebral Palsy (CP) by the study on the developing mechanism of labor contractions. Rational: Fetal periventricular echo density (PVE) precedes preterm neonatal PVL and CP in 18% of preterm fetuses whose PVE persisted until preterm births. Since no treatment of neonatal PVE appeared immediately after preterm birth was established, another strategy is proposed to prevent preterm neonatal PVE to cease preterm labor until the full term delivery, because no CP developed in full term delivery in our report. Recently, we studied the positive feed-back loop of uterine contraction to the brain by nerves between the uterus and hypothalamus, developing regular labor contractions. Proposal: The suppression of the nerves of positive feed-back loop by anesthesia or analgesia is our proposal to cease preterm labor until the full term delivery, where no CP was reported, i.e. the CP, corresponding to 0.2% of total births, will be reduced. Conclusion: Regular preterm labor contractions will be ceased by the paralysis of nerves in the positive feed-back loop between the uterus and hypothalamus and the full-term delivery prevents CP, due to disappeared PVE in the neonates born in full term delivery. Clinical feasibility should be investigated in further studies.
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