Anaesthesia for preterm delivery is discussed. This chapter describes the definition, aetiology, diagnosis, and management of preterm labour and delivery with a focus on tocolytic therapy, the use of antenatal corticosteroids, and of magnesium sulphate. Preterm labour is a common cause of neonatal morbidity and mortality. Chemoradiation using cisplatin or 5-FU/mitomycin C-based schedules has been reported but no randomized comparison with radiotherapy alone has been undertaken whilst high response rates are seen there is a considerable increase in acute toxicity. This must be balanced against the increased risk of lymphoedema where both surgery and radiotherapy are delivered to the groins. Postoperative radiotherapy should be considered for women having more than one node involved with metastatic tumour at surgery. The first station regional lymph nodes in the inguinal region are best treated by radical surgical dissection, but fixed inoperable lymph nodes may benefit from primary radiotherapy which may be followed where appropriate by surgery if there is a residual mass. Postoperative radiotherapy is recommended for tumours invading >7 mm in a vertical direction. Rarely, locally advanced primary disease may be presented for primary radiotherapy treatment. Chapter 9b discusses carcinoma of the vulva, which is primarily a surgical disease best treated by wide surgical resection, radical vulvectomy, and inguinal lymph node dissection based on presenting stage.
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