Premature deliveries participate in a significant way in the perinatal mortality of neonates. Extreme immaturity is frequently also the cause of neurological and mental handicaps of children. In the Czech Republic their rate varies between 5 - 6 %. The most frequent cause of onset of early uterine activity are infections. The most frequent agent are streptococi of group B (GBS). Chlamydiae, mycoplasmas, Trichomonas and bacterial vaginitis. Bacteria produce proteases and lipases, which interfere with the integrity of the amnion and cause premature escape of amniotic fluid. In developed chorioamniitis phospholipases are released, which induce via arachidonic acid prostaglandin synthesis from phospholipids and the latter causes uterine contractions. In the diagnosis ultrasonic assessment of the length of the uterine cervix is preferred. Many authors use detection of fibronectin in the cervicovaginal secretion. Its presence increases significantly the risk of premature labour. In the treatment tocolytic drugs of the series of beta-sympathomimetics are used in combination with magnesium preparations. Antibiotics are decisive in the treatment of chorioamniitis. Corticoids administered to the mother increase in the foetus production of surfactant and reduce the risk of respiratory distress syndrome (RDS). In case of premature escape of amniotic fluid it is necessary to admit the mother to hospital and monitor initial signs of intraovular infection (leukocytes, C-reactive protein). In the amniotic fluid the levels of glucose, leukocytic esterase and interleukin-6 are assessed. The method of choice is amnioinfusion. The greatest success of contemporary care in the CR is concentration of premature deliveries in Perinatological centres. Transport „in utero“ and provision of emergency care to the immature neonate by a neoatologist substantially reduced the early neonatal mortality. The total neonatal mortality in 1997 reached the historically lowest value of 5.1 pro mille and included thus the CR among the few countries in the world with the lowest neonatal mortality.

        Key words: premature labour, etiology, treatment, centralization, perinatological centres.