title: [Incidence of inflammatory placental changes in threatened premature labor with and without additional antibiotic therapy].
abstract: Considering the causal association of silent intrauterine infection and prematurity we investigated the possible effect of adjuvant antibiotic treatment of women with preterm labour on the appearance of inflammatory placental lesions. 140 patients with preterm labour in the 30 + 2 week of gestation (median; range: 17 + 2-34 + 6) without premature rupture of the membranes and detection of facultative-pathogenic micro-organisms in the vagina and/or in the canal of the cervix were enrolled in the study. 74 women were treated vaginally (polyvidone-iodine) in addition to intravenous tocolysis, 66 women were given ampicillin, cefotiam or erythromycin intravenously. After delivery the placentas were examined histologically and the frequency of inflammatory lesions was evaluated by use of 4 scores of classification. For statistical analysis the Fisher Exact- and the Wilcoxon Rank Sum Test were used. We found no differences concerning amnamnestic and perinatal parameters comparing the 2 groups of patients. With only one of the histological scores used (according to Salafia et al. [18]) we found a higher frequency of inflammatory placental lesion in the antibiotic treated group (12/66) in comparison to the vaginal treated group (4/74). Fifty patients of the antibiotics' group received the antibiotic during the last 10 days before birth. No differences in the frequency of inflammatory placental lesions were detectable in these patients when compared with the local treated group. However, we found a lower prolongation of gestation (calculated from the day of admission to the day of delivery, median: 7; range: 1-92 days) and a lower gestational age at delivery (median: 33 + 0; range: 22 + 2-39 + 6 weeks) in the patients receiving antibiotics during the last 10 days before birth in comparison to the local treated women (22; 1-138 days and 35 + 0; 23 + 4-41 + 5 weeks, respectively). There is the same incidence of inflammatory placental lesions in patients with preterm labour and facultative-pathogenic micro-organisms in the vagina and/or in the canal of the cervix who received adjuvant antibiotic treatment during pregnancy compared with patients who were treated vaginally with polyvidone-iodine.
authors.affiliation: Frauenklinik, Rheinisch-Westfälischen Technischen Hochschule (RWTH) Aachen.
authors.forename: M
authors.initials: M
authors.lastname: Winkler
authors.forename: S
authors.initials: S
authors.lastname: Biesterfeld
authors.forename: K L
authors.initials: KL
authors.lastname: Marquet
authors.forename: U
authors.initials: U
authors.lastname: Heindrichs
authors.forename: W
authors.initials: W
authors.lastname: Rath
mesh_terms: D000282:Administration, Intravaginal; D000667:Ampicillin / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis; D015310:Cefotiam / Q000008:administration & dosage; D002821:Chorioamnionitis / Q000473:pathology* / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004917:Erythromycin / Q000008:administration & dosage; D005260:Female; D005280:Fenoterol / Q000008:administration & dosage; D005322:Premature Rupture of Fetal Membranes / Q000473:pathology* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation; D007262:Infusions, Intravenous; D007752:Obstetric Labor, Premature / Q000473:pathology* / Q000517:prevention & control; D010920:Placenta / Q000473:pathology; D010922:Placenta Diseases / Q000473:pathology* / Q000517:prevention & control; D011206:Povidone-Iodine / Q000008:administration & dosage; D011247:Pregnancy; D015145:Tocolysis; D015149:Tocolytic Agents / Q000008:administration & dosage
chemical_list: D015149:Tocolytic Agents; D005280:Fenoterol; D004917:Erythromycin; D000667:Ampicillin; D011206:Povidone-Iodine; D015310:Cefotiam
vernacular_title: Zur Häufigkeit entzündlicher Plazentaveränderungen bei drohender Frühgeburt mit und ohne antibiotische Zusatztherapie.