[Etiologic classification of premature labor and its importance for prevention]

A retrospective analysis of 202 premature deliveries before 37 weeks was performed to identify major pathologies related to preterm delivery. The most frequent pathologies were premature rupture of membranes (32.4%), premature labour without recognisable aetiology (19.1%), hypertensive diseases in pregnancy (15.6%), multiple pregnancies (14.4%), malformations (9.8%) and bleeding in the 3rd trimester (6.4%). The majority of premature deliveries are related to 4 major pathogenetic disturbances: infection, problems of placentation, pathology of the foetus, pathology of the uterus. Each of these pathologies can lead to premature delivery via premature labour, premature rupture of membranes or termination of pregnancy for foetal or maternal pathology. In one third of premature labour, in another preterm premature rupture of membranes with labour after a variable latent period led to delivery, and in the remaining third, delivery was performed by a primary caesarean section or induction of labour for foetal or maternal pathology. Less than 25% cases were considered as failures of tocolytic treatment. Tocolytics, steroids or antibiotics, may help to improve the survival-rate in particular with very low birth-weight infants at less than 30 weeks gestation. A decrease in the overall rate of prematurity can be achieved only by a general improvement of the socio-economic working and living conditions of the female population, in particular of pregnant women.