ISSN:
1433-0393
Schlagwort(e):
Schlüsselwörter Frühgeburtlichkeit
;
Chlamydieninfektion
;
Bakterielle Vaginose
;
Vorzeitiger Blasensprung
;
Keywords Prematurity
;
Chlamydial infection
;
Bacterial vaginosis
;
Premature rupture of membranes
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Beschreibung / Inhaltsverzeichnis:
Abstract Genital infection, particularly bacterial vaginosis (BV), increases the relative risk of prematurity. Detection of disturbances of vaginal milieu at an early stage and the use of suitable countermeasures such as intervention with antimicrobial substances can reduce the preterm birth rate. Pregnant women being given prenatal care in 16 of the 29 outpatient offices in Erfurt, have been informed about the Prematurity Prevention Programme and have been offered to take part and to perform self-measurements of their vaginal pH twice a week in order to screen for any disturbances in the vaginal milieu. The pregnant women taking part in the programme were instructed to see their physician immediately, if abnormal values (pH ≥ 4.7) were present, in order to get them conformed and to start lactobacillus acidophilus therapy or, in case of BV, to treat with clindamycin cream i. vag. Patients being given prenatal care in the 13 outpatient offices not participating and other pregnant women who were not interested in the programme served as control group. Up to now 73 out of 381 women in the intervention group have been identified as risk cases. 58 of them were treated with a lactobacillus preparation, and 24 additionally with clindamycin cream, 3 patients refused to have any therapy. In this ongoing study the prematurity rate was 8.1% in the self-measurement/intervention group vs. 12.3% in the control group (n = 2.341); 0.3% vs. 3.3% of the neonates belonged to the group of very early prematures with a gestational age of 〈 32+0 weeks (p 〈 0.01). PROM was registered in 22.8% vs. 30.8% (p 〈 0.001) respectively. Self-measurement of vaginal pH at close intervals, as recommended by Sailing, leads to the early identification of women at risk for prematurity. Earliest possible intervention by the obstetrician appears to result in reducing the rate of prematures and in particular of very early prematures (〈 32+0 weeks).
Notizen:
Zusammenfassung In 16 der insgesamt 29 Erfurter Frauenarztpraxen wurde Schwangeren angeboten, an einer Frühgeburten-Vermeidungs-Aktion teilzunehmen. Interessierte Patientinnen erhielten Informationsmaterial sowie eine Meßausstattung und wurden angeleitet, vaginale pH-Messungen 2 × wöchentlich selbst vorzunehmen. Die Schwangeren waren dahingehend aufgeklärt, bei erhöht gemessenen pH-Werten (≥ 4,7) oder anderen Auffälligkeiten ihren betreuenden Arzt umgehend zu konsultieren, um gegebenenfalls mit Lactobacillus-Präparaten oder bei gesicherter Bakterieller Vaginose mit Clindamycin-Creme i. vag. behandeln zu lassen. In der Untersuchung wurden 73 von 381 Frauen in der Interventionsgruppe als risikobelastet identifizert. 58 von ihnen wurden mit der Lactobacillus-Zubereitung behandelt, 24 z. T. darüber hinaus mit Clindamycin-Creme. 3 Schwangere entzogen sich der Therapie. Die Frühgeburtenrate betrug 8,1% unter pH-Selbstmessung bzw. Intervention vs. 12,3% in der Kontrollgruppe (n = 2.341). 0,3% vs. 3,3% der Neugeborenen zählten zur Gruppe der frühen Frühgeborenen mit 〈 32+0 Schwangerschaftswochen (p 〈 0,01). Ein vorzeitiger Blasensprung trat in 22,8% vs. 30,8% (p 〈 0,001) auf.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/s001290050557
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