Premature birth risk

Presence of uterine contractions with a minimum rhythm of 4 contractions per 30 minutes, between the 22nd and 37th week of gestation.

80% of preterm labour risk consultations do not end up in preterm labour. Two thirds of the cases will not go into labour in the following 48 hours and more than a third will end up being full-term labours. It is the main cause of neonatal death.

Different materno-foetal factors come into play that may activate the labour mechanisms: pregnancy hypertension, placenta previa, amniotic liquid infection (chorioamnionitis), acute foetal suffering, etc.  

It manifests similarly to delivery work such as lower abdominal pain, lumbar pain, sensation of pelvic pressure and increase of uterine hardness along with the contractions. It can also be accompanied by increased vaginal discharge or genital haemorrhage.

The suspected diagnosis is clinical, through questioning and gynaecological exploration. It will be confirmed after a gynaecological screening and a CTG. A blood sample will be extracted to be able to study the anaemic and coagulation state and also, biochemical markers quantification such as the foetal fibronectin test.

Treatment will be based on stopping the delivery dynamic also called tocolysis, foetal lung maturity with corticosteroids and foetal neuronal prophylaxis. The pregnant woman will be at rest and, on some occasions, admitted to the Obstetrics Emergency Department to constantly monitor the mother and the foetus. If the onset is a premature membrane rupture, antibiotic treatment will be administered.