Any birth before the end of 37 completed weeks of pregnancy, or 39 weeks gestation, is considered premature. Preterm delivery can be spontaneous or triggered when the life of the mother and / or child is threatened. It requires the reception of the baby in a maternity hospital at an appropriate level at the end of the pregnancy.

Prematurity is a birth that occurs before 37 weeks of amenorrhea (SA) or 35 weeks of pregnancy. The duration of a full term pregnancy is 41 weeks, or 39 weeks of pregnancy. Most preterm births are spontaneous. Several causes can explain a preterm birth:

• Maternal infection, the most common being urinary tract infection.
• An infection of the cervix and vagina
• Multiple pregnancy
• A uterine malformation or fibroid
• An abnormally inserted placenta
• Intense fatigue, significant stress …

There are risk factors for premature birth: history of premature birth, underweight or obesity, age (under 18, over 35), smoking, etc.

Spontaneous premature birth is associated with preterm labor or premature rupture of fetal membranes. Premature labor corresponds to labor (contractions and changes in the cervix) before the end of pregnancy, before 37 full weeks of gestation, with or without rupture of the fetal membranes (water bag). Rupture of fetal membranes before 37 weeks of pregnancy often results in premature labor.

If you are pregnant and have preterm contractions (even if they are not painful), feel the baby is low, or think you are bleeding (loss of amniotic fluid may be slight), it is important to consult quickly.

Treatment can be started to stop the contractions and you can be hospitalized in an adapted maternity unit at the end of your pregnancy (level 2 or 3) when you show signs of preterm delivery.

It is not possible to avoid all premature deliveries (and moreover some spontaneous or induced premature deliveries aim to save the baby) but it is possible to act on the risk factors: stopping smoking, more rest in the event of multiple pregnancy, special monitoring in the event of a history of premature childbirth or in the event of extreme age.

Threat of premature birth: what to do?

If a diagnosis of threatened preterm labor is made, treatment is to identify the cause and treat it if possible. Rest at home or at the hospital in the pathological pregnancy department is then necessary in order to decrease uterine contractions and delay childbirth as long as possible. When the threat of premature labor is severe, the mother may be given corticosteroid injections to cause the baby’s lungs to mature quickly, and prevent pulmonary complications at birth.

If drug therapy administered to stop the contractions and stop labor in the event of a threat of premature labor have failed, childbirth takes place. The expectant mother is transferred to an adapted maternity unit at the end of her pregnancy: type 2 (neonatal unit, and intensive care unit in addition for level 2B maternities) for childbirth and type 3 (neonatal unit, unit intensive care unit and neonatal resuscitation unit). A complete team is present at birth with one or more pediatrician (s)

Premature birth is not always spontaneous. It can be induced, that is to say decided by the obstetric team when there are risks for the mother and the child. The most frequent pathologies at the origin of a childbirth decided before term? Severe hypertension (preeclampsia) intrauterine growth retardation (IUGR), maternal hemorrhage. The onset of childbirth before term is performed vaginally or by cesarean section.