醫療新知

Preterm delivery, approximately 5%-10% of all pregnancy, takes place during the 20th and the 37th weeks of pregnancy; they takes up 80% of the neonate death. Due to the progress of medical science, there are new inventions of the medical instrument and medicine, so the preterm newborn survival rate has grown higher. However, neonatal intensive care is expensive and it is usually a heavy burden to both the family and society. If a baby stays in its mother’s womb longer than 37 weeks, infant survival rate is greatly increased and sequela risks are reduced; it would then be easier for the parents to foster such a baby and to save up an extensive amount of medical expenses. 

• poor nutrition
• smoking, drinking, drug abusing
• overworking
• current pregnancy is too close to the former pregnancy
• poor hygiene
• too young or too old 
• underweight before the pregnancy
• unmarried
• artificial abortion
• low socio-economic status

Though reasons for most premature deliveries are unknown, we would like to provide the following causes to help you understand premature delivery: 

1. Early rupture of membrane: 90% of the early membrane rupture induces uterine contraction within 48 hours and the reason for it is unknown.
2. Infection: 1/3 of the premature delivery has something to do with amnion infection.
3. Previous early or late trimester premature delivery.
4. Oversized uterus: having too much amniotic fluid, or giving birth to multiple gestation
5. Cervical incompetence.
6. Abnormal uterus, like double uterus
7. Placenta previa or early placenta separation.
8. Intrauterine device
9. Elective induction; medically-approved for early induction of the baby.

Early signs include: persistent lower back pain, increased vagina secretion or bleeding, and uterine contraction. Do not underestimate minor symptoms as well. We thus designed a system assessing risk factors that most pregnant women possess based on their socioeconomic status, past pregnancy history, daily lifestyle, and current pregnancy; and factors are: 

1. Women with premature delivery: when their 1st baby is premature, their chance of having another premature baby is 3 times greater than other mother-to-bes. 
2. Cervical dilatation: if the cervix is dilating or thinner during pregnancy, there is a greater chance of premature delivery. 
3. Symptoms like lower abdominal pain, vaginal bleeding, and backache.
4. Oversized uterus caused by multiple gestation, overgrown fetus, polyhydraminos, and uterine myoma. 
5. Urinary tract infection. 
6. Vaginitis. 
7. Anemia.
8. Smoking and drug addict.
9. People with systemic disease. 

1. Regular prenatal care：Medical staff would help patients notice any possible conditions that might incur premature delivery. 
2. Avoid long distance travel
3. avoid overworking
4. avoid anxiety and agitation 
5. Seek for medical advice as soon as possible if there is premature delivery sign.
6. adjust activity during pregnancy：

If premature delivery is unavoidable, within a possible range, patients should go to hospitals providing intensive care facility for neonatal, so premature infants have no trouble receiving thorough proper care.

中國醫藥大學附設醫院

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