Contents
What is a MAP?
The Threat of Premature Childbirth (PAD) associates painful and regular uterine contractions and / or changes in the cervix in terms of length, opening or consistency. It can sometimes be accompanied by premature rupture of the water bag or bleeding from the uterus. These warning signs of childbirth unfortunately occur too early, since we only talk about PADbetween the 22nd and 37th week of amenorrhea (from 4 and a half months to almost 8 months of pregnancy).
Threat of preterm birth: three degrees of severity
- We distinguish three degrees of severity. When the contractions are small and the cervix is little modified, we speak of mild PAD. Fortunately, this is the most frequent case.
- It is called moderate when the contractions are important and the cervix is markedly shortened or dilated.
- Finally, a “severe” PAD is mentioned when the cervix is dilated by at least 4 cm and there is a flow of amniotic fluid or blood.
Namely
The term of pregnancy is an important consideration regarding the severity of this threat – the earlier in the pregnancy, the more serious it is.
Childbirth: the warning signs of PAD
While some signs such as bleeding, fluid discharge, fever or urinary burns can be easily identified by the expectant mother, contractions, sometimes mistaken for simple abdominal tension, or lower back pain, may go unnoticed. . It is therefore advisable for expectant mothers to do not hesitate to consult in case of doubt.
Threatened preterm birth: women at risk
Some mothers are more at risk than others because they present certain risk factors during pregnancy. In particular if they are under 18 or over 40, if they have a tiring life with long daily commutes to work, a strenuous job, many stairs, more than four dependent children or previous pregnancies close together, have had more than three abortions or miscarriages, also if they have a malformation of the uterus. The risk is also higher in women who smoke more than 10 cigarettes per day, but this does not mean that they will necessarily develop PAD. These risks are generally identified by the obstetrician or midwife during the first pregnancy consultation.. Preventive measures can thus be quickly implemented.
MAP: the main causes
Some expectant mothers do not present any risk factors and yet they develop a threat of premature labor. There are many causes. Among them, we find in particular the urinary tract infectionsvaginal or bacterial origin, but also distension of the uterus in case of excess amniotic fluid or multiple pregnancy, abnormalities of the positions of the placenta (placenta previa) or premature rupture of the membranes (cracked water bag). Certain trauma such as a fall or surgery during pregnancy can also lead to PAD.
Threatened premature birth: the necessary examinations
The purpose of the prescribed examinations is to find the causes and assess the severity of PAD. We usually start with a blood or urine laboratory examination to detect an infection. From ultrasounds and vaginal exams make it possible to assess the condition of the cervix or to detect a uterine malformation. Finally, ultrasounds and monitoring sessions are essential to monitor the fetus, the frequency of contractions as well as the amniotic fluid and the placenta.
Treatments considered in the event of a threat of premature labor
The treatments considered depend on the cause and the extent of the PAD. They start with rest – the pregnant woman is bedridden – which ranges from a simple reduction in activity to hospitalization with ban on getting up. To stop uterine contractions, intravenous injections of tocolytics (anti-contraction drugs). For accelerate fetal lung maturation in the event that the birth is imminent, corticosteroids are given. In case of infection, antibiotics are prescribed.
Namely
For severe PAD, transfer of the mother to a level III maternity unit (with neonatal resuscitation unit) is considered.
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