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DOI: 10.1055/s-0032-1325059
Die Frühgeburt – Prävention, Diagnose und Interventionen
Publication History
Publication Date:
05 July 2013 (online)
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Die Ursache einer spontanen Frühgeburt ist meist multifaktoriell und umfasst beeinflussbare und nicht beeinflussbare Risikofaktoren. Präventiven Einfluss auf die Frühgeburtenrate haben Maßnahmen zum Infektionsscreening, aber auch die intramuskuläre oder vaginale Applikation von Progesteronpräparaten. Zur Diagnostik bei symptomatischen Patientinnen eignen sich vaginalsonografische Verfahren zur Messung der Zervixlänge sowie die Bestimmung des fetalen Fibronektins im Vaginalsekret bzw. die Kombination der beiden Methoden. Bei bestehender Zervixinsuffizienz und stark verkürzter Zervix (< 15 mm) kann eine Cerclage indiziert sein. Droht eine Frühgeburt nach der 23. SSW, sind Maßnahmen zur Tokolyse für die Dauer von 48 h gefordert, um die fetale Lunge reifen zu lassen. Im Zeitraum bis 24 h vor einer wahrscheinlichen Frühgeburt hat sich Magnesiumsulfat als effektive neuroprotektive Maßnahme erwiesen. Peripartale Antibiotikagaben verringern das Risiko einer neonatalen Gruppe-B-Streptokokken-Infektion.
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