Premature delivery

One of the most severe complications related to pregnancy is a delivery before the 34th week.

NEOA premature delivery is defined by regular contractions of the uterus before the 37th week of pregnancy which also includes changes in the cervix (the cervix begins to dilate). Untimely breaking of waters may occur.

It is almost impossible to determine an untimely delivery during the beginning of the pregnancy. Risk factors may include previous untimely births or miscarriages, chronic diseases of the mother, multiple pregnancy, malformation of the foetus, bleeding during pregnancy, infections in the vagina or in the uterus, premature braking of water, poor social circumstances.

Babies born on the 22nd to 28th week (5th to 7th month) make up about 0.4% of all live births, they weigh from 500 to 1000 g. The ones born on the 29th to 32nd week of pregnancy (7th to 8th month) make up about 9.3% of the babies, weighing at 1000 – 2500 g. About 80% of all premature babies are born during the 32nd to 36th week of pregnancy. The birth of up to one quarter of babies is medically induced before the 37th week if the lives of the baby or the mother are at risk.

Premature birth is a big concern for the parents. The treatment and care for the baby may end up being very long and complicated, financially burdening and psychologically taxing for the parents. Premature babies have a lot of serious health issues, requiring special care and monitoring. If possible, the mother at the risk of premature delivery is assigned to a central hospital (Tallinn, Tartu). Intrauterine transport is safest for the baby. Intensive care and survivability and further quality of life for such babies is the highest at medical centres with the highest number of patients, due to having the required staff, technology and experience stemming from the high amount of birth experience.

More than half of Estonia’s premature babies are born at East Tallinn Central Hospital (ITK) maternity hospital, where all emergency and problematic birth givers are sent from western and northern Estonia.

ITK has contributed a lot to their 8-bed newborn intensive care ward and quality of care in the last 10 years. We started improving the maternity hospital’s intensive care unit 12 years ago after seeing that the condition of newborns deteriorated rapidly during transport. The main goal of caring for very premature newborns is to minimize the deterioration of the new-borns’ health and further diseases during the newborn age, specifically conditions such as BPD (chronical lung illness), bleeding in the ventricular system (IVH), cystic periventricular leukomalacia (cystic damage do the brain’s white matter – PVL), retinopathy of premature babies (eye disease caused by prematurity – ROP) and necrotising enterocolitis (infectious digestive illness – NEK) – caused by prematurity and avoiding further complications and even death. The less aggressive care applied during the first hours and days of life has a vital connection to the mortality rate and diseases of newborns and a positive effect on a child’s later health and development.

The only breastmilk donor bank in Estonia, founded in 2010 and providing newborns in need with breastmilk, has contributed greatly to the improvement of the results. Donor milk is given to severely premature babies until the biological mother can produce enough milk of her own.

At our hospital, we use minimally invasive and aggressive intensive care for premature babies born here, resulting in a decreased number of very small newborns who were alive at the end of primary hospital treatment and who did not suffer from diseases of newborn age which impact the development of a premature baby.


Additional reading:

Article: Treatment response of very premature newborns in Estonia.

Article: Comparison of care regime of respiratory disorders of very premature newborns during three periods at East Tallinn Central Hospital.

Research: The quality of care of premature newborns in Estonia must be improved

The stopping of premature delivery is of high importance when it comes to the health and survivability of the newborn. Modern research-based treatment methods are used – prolonging the pregnancy with medicine if possible, pre-delivery glucocorticoid treatment to prepare the lungs of the foetus, neuroprotection in order to protect the immature brain of the child/foetus and anti-inflammation treatment.

Should the symptoms of possible premature delivery emerge, please contact your gynaecologist or midwife. For a check-up you can always turn to our hospital’s emergency reception.

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