Preterm delivery: risk, cause and prevention

Preterm birth is an important perinatal health problem with a great impact worldwide; It can appear in up to 10% of pregnancies.

Developing countries are those that suffer the highest burdens in absolute terms, where premature births are responsible for approximately 75 to 80% of perinatal mortality (40% of these deaths occur in births less than 32 weeks).

Achieving an increase in the number of healthy survivors and improving or reducing premature birth, goes hand in hand with a better understanding of the causes and risk factors of prematurity, as well as offering quality medical interventions in a timely manner.

Preterm delivery is the one that occurs after the 22nd week of gestation and before the week 37 has been completed (259 days of gestation, counted from the first day of the date of the last menstruation). Preterm labor is the presence of regular uterine contractions that occur before week 37 of gestational age and that are associated with changes in the cervix (the channel that connects the uterus to the vagina). On the other hand, the threat of premature labor occurs when there is only increased uterine contractility, with no change in the cervix or cervix. Remember that it is normal to have contractions during pregnancy, but these are not rhythmic, regular, or painful.

Preterm delivery represents a risk for the newborn due to complications caused by immaturity or by the effect of the drugs used to manage it; Likewise, complications in the mother are related to the actions that these drugs produce at cardiac, renal and pulmonary levels.

In general, preterm delivery can be divided into two categories: the spontaneous, which represents 80%, which is multifactorial, with multiple clinical presentations that include preterm labor (50%) and premature rupture of the membranes or water bags (20%). The rest (20%) are planned and are due to maternal or fetal diseases such as: preeclampsia-eclampsia, placenta previa, placental abruption, intrauterine growth restriction, etc.

If labor begins before 34 weeks and there is no medical reason requiring immediate delivery, it is likely that the doctor will delay the same for a few days to offer the opportunity to deliver corticosteroids, which helps the baby to have his or her lungs develop faster, increasing the chances of survival and reducing the risks associated with preterm delivery; however, there are no reliable methods to stop or prevent preterm labor in all cases.

After being born, premature babies are taken to a Neonatal Intensive Care Unit. There they are placed in incubators, a closed plastic crib with controlled environment designed to keep them warm, since at birth they are exposed to external environmental factors, and their own physiological processes that put at risk the thermal stability.


Published in: Today Digital Newspaper

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