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2020 | Frühgeburten | OriginalPaper | Buchkapitel

12. Frühgeburt und Amnioninfektionssyndrom

verfasst von : Elisabeth von Tucher, Wolfgang Henrich

Erschienen in: Therapiehandbuch Gynäkologie und Geburtshilfe

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Die Identifikation des Frühgeburtsrisikokollektives ist essenziell und erfolgt durch die transvaginalen Zervixlängenmessung, vaginale Biomarkern (fFN, p-AMG, phIGFBP) und Identifikation maternaler und fetaler Risikofaktoren. Die Indikation zur intrauterinen Verlegung in ein Perinatalzentrum, zur Tokolyse und zur Lungenreifeinduktion ist in Abhängigkeit vom Gestationsalter und den fetalen Versorgungsansprüchen zu stellen. Zwischen 22 und 24 vollendeten Schwangerschaftswochen sollte interdisziplinär und im Konsens über eine lebenserhaltende oder eine palliative Therapie in jedem Einzelfall entschieden werden. Bei asymptomatischen Patientinnen ist Progesteron 200 mg intravaginal indiziert. Bei Schwangeren mit einer anamnestischen Frühgeburt bzw. einem Spätabort und einer vorzeitigen Zervixreifung ist die Cerclage oder das Pessar zu diskutieren. Bei vorzeitigen zervixwirksamen Wehen zwischen 24 und vollendeten 34 SSW erfolgt eine möglichst kurzzeitige Tokolyse. Im Abstand von 24 h ist zur Lungenreifeinduktion 2 × 12 mg Bethamethason zu verabreichen. Eine prophylaktische Antibiotikagabe ist bei vorzeitigen Wehen nicht indiziert, aber nach vorzeitigem Blasensprung obligatorisch.

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Titel: Frühgeburt und Amnioninfektionssyndrom
verfasst von: Elisabeth von Tucher
Wolfgang Henrich
Verlag: Springer Berlin Heidelberg
Buch: Therapiehandbuch Gynäkologie und Geburtshilfe
Print ISBN: 978-3-662-59808-5

Electronic ISBN: 978-3-662-59809-2

Copyright-Jahr: 2020
DOI: https://doi.org/10.1007/978-3-662-59809-2_12

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