Contents
Risk factors for premature labor
Infections
Mother’s infections
It is the most common cause of premature births. Whether they are in the vagina, urinary tract or teeth, these infections all result in inflammation that promotes the onset of contractions. Fever, which can accompany a viral illness like the flu, can also be a trigger on its own. The most common are vaginal infections such as bacterial vaginosis (due to Gardnerella vaginalis). In this case, the germs in question, already present in the normal state in the vaginal flora, proliferate and can tend to go up inside the cervix and the uterus. These infections are only sought during pregnancy in women at risk (history of premature labor, early contractions, changes in the cervix). Therefore, if in doubt, your doctor will order a urinalysis (ECBU).
Infections of the fetus
The best known is the chorio-amniotite, often following a rupture of the membranes. When the water bag breaks or cracks early, the fetus is no longer protected. He may be infected with germs from inside the vagina, which travel up through the cervix and can reach the amniotic cavity. Antibiotics work poorly and premature delivery is often inevitable.
It should be noted
Other factors such as unfavorable socio-economic conditions or tobacco consumption can also cause a rupture of the water bag and therefore a premature birth.
Multiple pregnancies
The woman who is expecting several children has one in two risk of giving birth prematurely. The reason is simple: two babies weigh heavier than one, their weight causes distension of the uterus, fibers are stretched, pressure increases inside the uterine cavity, contractions appear, leading to dilation. and premature opening of the cervix, as well as early rupture of membranes. It is moreover to prevent these premature deliveries that gynecologists and obstetricians now limit the number of embryos transferred in utero after in vitro fertilization (IVF). And then in some cases, it’s the doctors who cause the premature delivery if one of the babies shows any sign of weakness, for example.
The diseases of the future mother
High blood pressure
High blood pressure, often associated with a malfunction of the placenta, prevents the fetus from being properly nourished and therefore from growing and gaining weight. Which results in uterine growth retardation. Usually, doctors induce delivery so that the baby can be fed in an incubator, through a tube.
It should be noted
Lmaternal hypertension accounts for around 20% of deliveries before 33 weeks. It can be complicated with other pathologies such as pre-eclampsia, eclampsia or retro-placental hematoma.
Diabetes
Poorly balanced diabetes can lead to excessive growth of the fetus, enlargement of all of its organs, including the heart, and excess amniotic fluid. Childbirth can start early, spontaneously. It is also sometimes decided by the medical team to protect the baby and its mother.
In addition, gestational diabetes can appear during pregnancy.
Some women are considered to be at higher risk: those who are significantly overweight, have a history of diabetes in their family or have already given birth to large children.
Uterine malformations
When the cervix opens too easily, from the second trimester of pregnancy, we call that the gaping or the cervical incompetence. A woman can give birth prematurely, sometimes with few contractions. It is often a functional problem linked to a lack of resistance of the cervix, the tissue is too soft too early. In subsequent pregnancies, the mother-to-be may benefit from a strapping (tape to strengthen the tone of the cervix) and / or very close ultrasound monitoring.
Another anomaly, sometimes without knowing it, the woman has two small uterine cavities, instead of one large : it is a bicornuate or partitioned uterus. These malformations are sometimes unknown and go completely unnoticed. They are often detected during a miscarriage or a sterility assessment. As the fetus develops, it becomes cramped, the first contractions appear, the cervix dilates … With lots of rest and sometimes strapping, a woman often succeeds in continuing her pregnancy for a few more weeks. If she wants a second child, the septum between the two uteri may in some cases be surgically severed.
The position of the placenta
A low placenta, inserted near the cervix, can also be the cause of premature labor, especially when it is accompanied by bleeding. It can weigh and put pressure on the cervix and therefore promote its dilation.
Trauma
A car accident or a violent fall where the mother-to-be receives a shock on the stomach can be the cause of the onset of contractions and a rupture of the water bag. But this event is rather rare. Amniotic fluid protects the fetus and absorbs shock.
The role of socio-economic factors
Note: all the studies show that the risk of premature childbirth is all the more important as the socio-economic level of the pregnant woman is lower. In addition, working conditions play a significant role. The more laborious the labor, the more overworked the expectant mother, the greater the risk of premature birth.
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