Premature birth: Cesarean section or natural delivery?

Written by Liu Wen Li
Obstetrics
Updated on January 17, 2025
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Whether to opt for cesarean or vaginal delivery for preterm birth needs a comprehensive grasp of the pregnant woman's entire condition before assessing and deciding on the mode of childbirth. First, it's necessary to check if the woman has any complications and the severity of these complications, as well as whether her physical condition allows for vaginal delivery. Additionally, the changes in fetal heart rate must be considered. If the fetal heart rate is particularly poor, and the duration of vaginal delivery is long such that the child cannot endure it, then a cesarean section may be needed. Beyond these conditions, it is also important to evaluate the state of the pelvis, the size of the fetus, and the condition of the cervix. Generally, if vaginal delivery is possible for preterm births, it is still encouraged.

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Written by Zhang Lu
Obstetrics
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How is premature birth defined?

Preterm birth is defined in relation to miscarriage and full-term birth. A birth before 28 weeks of pregnancy is considered a miscarriage; a birth after 37 weeks of pregnancy is considered full-term; and a birth between 28 weeks and 36 weeks and six days is considered preterm. Since preterm birth occurs in the late stages of pregnancy, the fetus has a certain chance of survival. However, efforts should be made to delay the timing of preterm birth as much as possible to increase the survival rate of the fetus. It is generally believed that births between 28 and 34 weeks are considered early preterm, during which the survival probability of the fetus is relatively low; whereas births after 34 weeks up to 36 weeks and six days are considered late preterm, during which the maturity of the fetus is higher and the survival rate is also relatively high.

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Written by Zhao Li Li
Obstetrics
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What are the symptoms of preterm labor?

According to the current situation, generally, embryos delivered between 28 to 37 weeks of cessation of menstruation are considered preterm. Under normal circumstances, if there is already regular abdominal pain accompanied by abdominal bloating and uterine contractions, it is generally considered whether there is a possibility of threatened miscarriage. Normally, frequent uterine contractions and abdominal hardening can stimulate cervical dilation, which generally may lead to preterm birth. Therefore, these are the signs of preterm labor. If regular abdominal pain occurs and persists for several hours without relief, it is advisable to seek medical attention promptly for treatment to prevent premature birth.

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Written by Zhao Li Li
Obstetrics
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Causes of Premature Birth

Generally, there are many reasons that can cause symptoms of preterm birth. Normally, due to reasons such as cervical dilation, or the occurrence of regular abdominal pain, preterm labor may be induced. In some cases, long-term vaginal inflammatory conditions can lead to premature rupture of membranes, or cervical canal dilation may also cause preterm birth. If symptoms of preterm birth occur at present, it is necessary to actively suppress contractions, protect the fetus, and provide symptomatic treatment. If this is ineffective, it is advisable to actively prepare for rescuing and caring for the newborn.

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Written by Zhang Lu
Obstetrics
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Definition of premature birth date

Premature birth, compared to miscarriage and full-term birth, is defined differently. A miscarriage refers to childbirth before 28 weeks, and a full-term birth is one that occurs after 37 weeks. Births that occur between 28 weeks and 36 weeks plus 6 days are collectively referred to as premature births. During this period, the fetus is relatively larger and has a certain level of maturity, so the survival rate is relatively high. However, it still falls short when compared to full-term infants. Generally, 34 weeks is used as a boundary: infants born from 28 to 34 weeks are referred to as early preterm, while those born between 34 weeks and 36 weeks plus 6 days are considered late preterm. Therefore, premature births are divided into these two main categories. In clinical practice, if there are signs of premature birth, it is recommended to try to extend the gestational age and aim for childbirth during the late preterm period.

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Written by Du Rui Xia
Obstetrics
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How to prevent preterm birth

The causes of preterm birth are numerous, and prevention mainly involves addressing these causes. For etiological reasons, proactive treatment of some chronic diseases is necessary. For pregnant women with a history of preterm birth, it is crucial to pay close attention two to three weeks before the previous preterm birth date. They should avoid overexertion, abstain from sexual activity, and rest in bed until the expected due date. It is also important to identify the causes of preterm birth, such as cervical insufficiency. If so, a cerclage surgery can be performed around the 14th week of pregnancy. If a pregnant woman shows signs of labor or preterm birth, she should be given oxygen immediately, and an injection of vitamin K should be administered to prevent intracranial hemorrhage in the newborn.