[Premature labor, determination of fetal lung maturity and medicamentous induction of lung maturation].
Preterm delivery continues to be one of the main causes of perinatal mortality and morbidity, comprising about 8% of all deliveries. The percentage of the most jeopardized preterm newborns weighing less than 1500 g is about 1, however, can be several fold higher in perinatal centers. Respiratory distress syndrome, intracranial hemorrhage, persistent fetal circulation as well as enterocolitis represent prominent complications. Avoiding preterm delivery in cases of preterm labor is attempted by application of magnesium sulfate, beta sympathomimetics or non-steroidal antiphlogistics. Is preterm delivery desirable, however not absolutely indicated, knowing the status of the fetal lung maturity may be helpful in the decision making process. This can nowadays best be achieved by determining the surfactant albumin-ratio by possibly repeatedly withdrawing amniotic fluid by amniocentesis. When inducing lung maturation, application of corticosteroids crossing the placenta is favoured. With impending preterm delivery this should always be given a try, independent from the time expected to be left until delivery- and also below the completed 27th week of pregnancy. Prenatal induction of lung maturation and postnatal application of surfactant are to be looked at as complementing therapeutic concepts in the immature neonate.
Baumann
P
P
Klinik für Frauenheilkunde und Geburtshilfe, Medizinischen Universität zu Lübeck.
Diedrich
K
K
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000653:Amniotic Fluid / Q000737:chemistry; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000032:analysis; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D011663:Pulmonary Surfactants