Frühgeburtlichkeit

Kernaussagen

Die Erwartung, das Problem der Frühgeburtlichkeit könnte in naher Zukunft gelöst sein, wäre unrealistisch. Im Gegenteil: Aufgrund der vielgestaltigen ätiologischen Aspekte dieses Syndroms und vor allem durch das sich verändernde Risikopotenzial der Schwangeren wird dieses Problem in der klinischen Arbeit eher an Bedeutung gewinnen. Ziel muss es sein, die Diagnostik zu verbessern, um die Therapie zielgerichteter zu gestalten. Denkbar ist es, dass neue Methoden der „High-dimensional Biology” wie Erregeridentifizierung durch Chips oder Bedside-Diagnostik von Inflammationsparametern im Fruchtwasser Risikopatienten und Risikosituationen (Infektion, FIRS) früher identifizieren, um fokussierter eine „Aetiology-tailored” Behandlung einzuleiten. Diese zu erhoffenden wissenschaftlichen Fortschritte müssen flankiert sein von entsprechenden strukturell-organisatorischen Maßnahmen wie Zentralisierung in Perinatalzentren und selbstständige Leitung großer geburtshilflicher Einrichtungen durch qualifizierte Perinatalmediziner.

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