[Indicated preterm birth in a type 3 maternity ward: Evaluation of practices].
The purpose of this study was to evaluate the proportion of indicated preterm births among all preterm births in a type 3 maternity ward; to assess practices in terms of mode of delivery in such cases; and to analyse the observed outcomes for such deliveries.


METHODS
A retrospective study was conducted in the obstetrics department of the regional university hospital of Tours (type 3 maternity ward) over a 22-month period. Women with an indicated preterm birth between 22 and 37 weeks of gestation, for whom vaginal delivery was possible, were included in the study. For every woman, the choice of mode of delivery (caesarean before labour or induction of labour) as well as maternal, obstetrical and neonatal factors were recorded.


RESULTS
From January 2012 to October 2013, 539 deliveries were preterm among which 42.5% were indicated preterm births. Out of 114 women for whom vaginal delivery was possible, 33.3% had a caesarean before labour and 66.7% had an induction of labour. The choice of mode of delivery is influenced by various factors such as local conditions, gestational age and type of obstetrical pathologies. Moreover, birth weight and Apgar score are significantly lower and the hospitalisation rate of newborns is significantly higher in the "caesarean before labour" group.


CONCLUSIONS
Indicated preterm births represent almost half of preterm births in the maternity ward. A third of these indicated preterm births were caesareans before labour. Due to the neonatal morbidity resulting from indicated preterm birth, it is essential to regularly reassess indications of indicated preterm birth.
Pôle de gynécologie-obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe-de-Gouges, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37000 Tours, France. Electronic address: vic.weymuller@wanadoo.fr.
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Weymuller
Pôle de gynécologie-obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe-de-Gouges, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37000 Tours, France.
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Diguisto
Pôle de gynécologie-obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe-de-Gouges, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France.
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Guellier
Pôle de gynécologie-obstétrique, médecine fœtale, médecine et biologie de la reproduction, centre Olympe-de-Gouges, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France; Faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37000 Tours, France; Inserm U930, faculté de médecine, université François-Rabelais, 10, boulevard Tonnellé, 37000 Tours, France.
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Perrotin
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007751:Labor, Induced / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies
Caesarean delivery; Césarienne; Déclenchement du travail; Indicated preterm birth; Labour induction; Morbidité néonatale; Neonatal morbidity; Prematurity; Prématurité; Prématurité induite