[Progress in diagnosis and treatment of pregnancies with low birthweight infants (author's transl)].
In order to prove the progress in diagnosis and treatment of pregnancies with low birthweight we performed a retrospective computer-analysis of three groups of patients including newborns below 2750 g delivered dumping the last 10 years. The first group contains the years 1967/68; the deliveries of low birthweight infants were monitored without cardiotocogram. The second group of patients from the years 1971/72 was monitored continuously during delivery by cardiotocogram. The endocrinologic diagnostic methods for detection of a possible placental insufficiency in low weight fetus were applied regularly (DHEA-S-loading test, oestriol, HPL). The treatment of premature newborns with respiratory distress syndrome was facilitated by CPAP. A thorough ultrasound diagnosis was available additionally for the third group of patients. Long term treatment with Partusisten was applied in cases of premature labour in this group and betamethasone-therapy was used for accelleration of fetal lung maturation. With a nearly constant number of preterm eutrophic newborns, preterm infants with retarded growth and mature infants with retarded growth over a period of ten years the unpurified mortality rate decreased from 14.3% to 6.7% when the pregnancies and deliveries had intensive (obstetrical medical) care. With the help of Shirodkar procedure and tocolytic treatment the birthweight could be shifted significantly into the favourable group over 2000 g. The prenatal prophylactical treatment of the respiratory distress syndrome with beta-methasone and the postnatal CPAP-therapy decrease the mortality rate caused by respiratory deficiency from 13.7% to 6.4%. The preventive caesarean section in cases of low birthweight infants with abnormal positions in utero helped to reduce the mortality rate from 21% to 10.6% in these cases. The accuracy of prenatal diagnosis of intrauterine retarded fetal growth by hormone analysis and ultrasonic measurement of the fetus was improved from 24% to 66%.
D005260:Female; D005860:Germany, West; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008991:Monitoring, Physiologic; D007752:Obstetric Labor, Premature / Q000517:prevention & control; D010927:Placental Insufficiency / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012189:Retrospective Studies; D014463:Ultrasonography
Fortschritte in der Diagnostik und Behandlung bei Schwangerschaften mit untergewichtigen Kindern (Statistische Analyse dreier Patientenkollektive der letzten 10 Jahre).