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Die Frühgeburt: Prädiktion, Prävention und Management

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Die Geburtshilfe

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Die Frühgeburt ist definiert als eine Geburt vor abgeschlossener 37. SSW. Sie trägt wesentlich zur perinatalen Morbidität und Mortalität bei. Durch die Identifikation von Risikofaktoren, die sonografische Messung der Zervixlänge und verschiedene biochemische Testverfahren können Hochrisikopatientinnen erkannt werden. Präventive Maßnahmen zur Senkung des Frühgeburtsrisikos sind primär, sekundär oder auch tertiär ausgerichtet. Je nach Befund ist die Applikation von Progesteron, die Anlage eines totalen Muttermundverschlusses und Zerklagebandes oder die Therapie mit einem Zervixpessar indiziert. Bei sehr hohem Frühgeburtsrisiko werden vor 34+0 SSW Kortikosteroide appliziert. Hiermit kann die perinatale Morbidität signifikant gesenkt werden. Ist die Frühgeburt nicht mehr aufzuhalten, sollte das unreife kindliche Gehirn mit Magnesium geschützt werden. Aufgrund von fetalen Lageanomalien ist häufig eine Sectio caesarea indiziert. Spätes Abnabeln vermindert die neonatale Morbidität, bei <28 SSW soll die Nabelschnur nicht ausgestrichen werden.

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Notes

  1. 1.

    Die schweizerische Gesellschaft für Gynäkologie und Geburtshilfe hat zu dieser Empfehlung der Leitlinie ein Sondervotum formuliert, das in ausgewählten Fällen eine Applikation antenataler Steroide auch bei drohender Frühgeburt zwischen 34+0 und 36+5 SSW erlaubt.

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Authors and Affiliations

  1. Frauenklinik, Marienhausklinikum, Neuwied, Deutschland

    Richard Berger

  2. Universitätsklinik für Frauenheilkunde, Klinische Abteilung für Geburtshilfe und feto-maternale Medizin, Medizinische Universität Wien, Wien, Österreich

    Hanns Helmer

  3. Universitätsklinik für Frauenheilkunde, Inselspital, Bern, Schweiz

    Henning Schneider

  4. Universitätsklinik für Frauenheilkunde, Inselspital, Universitätsspital Bern, Bern, Schweiz

    Daniel Surbek

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  2. Hanns Helmer
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  3. Henning Schneider
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  4. Daniel Surbek
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Correspondence to Richard Berger .

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  1. Frauenklinik, Medizinische Hochschule Hannover, Hannover, Niedersachsen, Deutschland

    Constantin von Kaisenberg

  2. Klinische Abteilung für Geburtshilfe, Medizinische Universität Graz, Graz, Steiermark, Österreich

    Philipp Klaritsch

  3. Geburtshilfe, Universitätsspital Basel, Basel Universitätsspital, Basel Stadt, Schweiz

    Irene Hösli-Krais

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Berger, R., Helmer, H., Schneider, H., Surbek, D. (2022). Die Frühgeburt: Prädiktion, Prävention und Management. In: von Kaisenberg, C., Klaritsch, P., Hösli-Krais, I. (eds) Die Geburtshilfe. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-44369-9_15-2

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  • DOI: https://doi.org/10.1007/978-3-662-44369-9_15-2

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  1. Latest

    Die Frühgeburt: Prädiktion, Prävention und Management
    Published:
    03 August 2022

    DOI: https://doi.org/10.1007/978-3-662-44369-9_15-2

  2. Original

    Frühgeburt: Pränatale und intrapartale Aspekte
    Published:
    16 March 2015

    DOI: https://doi.org/10.1007/978-3-662-44369-9_15-1

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