To reduce prematurity and its consequences we need to act on its different causes, for example by early screening for diseases that predispose to prematurity, like preeclampsia or infections during pregnancy, and by the prevention of the physical and psychological complications of premature birth. The aim is to set up effective care strategies and/or therapies that gain time and prolong pregnancy, without endangering the mother or fetus.

So, access to appropriate care is a major question that concerns first and foremost women in vulnerable or disadvantaged situations, but also all pregnant women. However, overmedicalization can be associated with a decrease in quality, multiplication of participants, lack of coordination, and lack of training. FHU PREMA aims to pool means and ideas with a view to improving the effectiveness of healthcare.

Operational objectives of FHU PREMA

  1. Harmonize management of the main obstetric and neonatal diseases.
  2. Improve the quality and safety of care through joint reviews of morbidity and mortality.
  3. Develop connected tools for outpatient management.
  4. Work with user and patient groups to respond better to their needs.
  5. Share clinical data and expedite the collection of clinical data in obstetrics and neonatology, in line with AP-HP strategies.

What is a perinatal center?

A perinatal center houses at one site a maternity unit, for the management of pregnant women, childbirth, and postnatal follow-up, and a neonatology unit. There are 3 types, depending on the level of pediatric care provided.

What are the types of maternity unit?

Maternity units are classified according to the level of care they provide:

  • Level 1 maternity units care for women whose pregnancy is in principle uneventful, and house an obstetric unit but not a neonatology unit.
  • Level 2a maternity units have a neonatology unit and provide care to infants born from 34/35 weeks of gestation.
  • Level 2b maternity units have a neonatal intensive care unit and care for infants born from 31/32 weeks of gestation.
  • Level 3 maternity units house a neonatology unit and a neonatal intensive care unit for all newborns who are ill, notably those born very prematurely (32 weeks of gestation [7 months]).

Some maternity units provide specialized care:

  • level 3 maternity units specialize in pediatric care for the immediate management, where necessary, of newborns with specific conditions (cardiac, gastrointestinal, and other malformations).
  • maternity units specialize in nonobstetrical maternal conditions that always call for collaboration between obstetricians and specialists in the illness concerned. These maternity units are not part of the classification by level.

FHU PREMA comprises 4 AH-HP clinical sites and the perinatal center of the Paris Saint-Joseph Hospital Group.