Prematurity
According to WHO (World Health Organization), a birth is premature if it occurs before 37 weeks gestation.We musn't forget that premature births account for approximately 6% of births in France.There are 3 types of prematurity according to the date of onset of delivery: :-Average” prematurity(between 32 and 37 weeks gestation), the most common (approximately 30 000 children in France) for which the prognosis is good. -The “great” prematurity(between 28 and 32 weeks gestation), it affects approximately 7000 children per year. In these cases transferal to a perinatal center are essential.. -The "very large" preterm (before 28 weeks gestation), whose numbers and prognosis are still poorly understood at present in France.We can define two types of preterm birth::-Induced”prematurity due to a voluntary fetal extraction indicated by obstetricians to save the mother and/or fetus. -Spontaneous” preterm birth is not triggered by doctors. Risk factors for preterm birth are:-RELATED TO THE EGG: -Multiple pregnancies with major risk 10 times higher than for singleton pregnancies -Placental abnormalities: Placenta previa, placentae -Bleeding during the second and third trimester (risk multiplied by 4) -Polyhydramnios (insufficient amniotic fluid) -RELATED TO THE UTERUS: -Congenital malformations of the cervix or uterus -Incompetent cervix congenital or acquired -Exposure to DES (Distilbène) in utero causing hypoplastic uterine, cervical and / or functional incompetence. This includes approximately 80 000 women born in France between 1950 and 1975 -Large fibroids distorting the uterine cavity or extensive synechia. LINKED TO STATE OF THE MOTHER: -History of premature birth or serious threat of premature delivery -History of induced or spontaneous abortion -Severe maternal fever, caused by bacteria (urinary tract infection, listeriosis) or viral -Cervicovaginal infections and STDs at the origin of ascending infections -Inadequate prenatal care -Low socio-economic statusHowever, in a high proportion of cases, no risk factor is found. Vigilance is therefore required for any pregnancy.
Victor Hugo