Basic aspects of prematurity prevention and results achieved by a suitable, simple program.
An urgent task for modern obstetrics is to reduce the number of unwanted very early prematures. Long-term impairments of these infants still occur too frequently. Ascending genital infections, particularly before 32 gestational weeks, are the most significant cause of prematurity. The best chance of preventing early prematurity is to employ a prophylactic screening program, preferably including self-pH-measurement by all pregnant patients and paying attention to all other important risk factors. The results of this "Prenatal Care Self-Examination" program are encouraging. The rate of very small prematures, with a birth weight of less than 1,500 g, in all 1,120 multigravidae who have taken part in this program is clearly lower, at 1.3%, than in immediate previous pregnancies when it was 7.8%. The rate of extremely small infants of less than 1,000 g amounted to 0.9%, compared with 3.9% in previous pregnancies. Results from a prospective study recently presented confirm in a convincing way what can be achieved in an entire city. In Erfurt, with 208,000 inhabitants and about 1,500 deliveries per year, all in the one maternity department in this city, 16 practitioners taking care of the pregnant patients, i.e. nearly one half of them in Erfurt, motivated their patients to take part in our prematurity prevention program with its "Prenatal Care Self-Examination", where the patients themselves measured their vaginal pH twice a week. The results are very interesting. In the group of 1,842 patients without prenatal self-examination activity, the frequency of very early prematures--i.e. less than 32 weeks gest.--was 3.3% (n = 61). In the group of 314 patients who performed prenatal self-examinations, the corresponding frequency was only 0.3% (n = 1). This is an eleven-fold, and significantly lower rate. On account of such positive results, a definitive step has been made with regard to practicability and efficiency of prevention of very early premature birth.
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D005260:Female; D005831:Genital Diseases, Female / Q000150:complications; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007234:Infant, Premature; D007239:Infections / Q000175:diagnosis; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D016353:Self-Examination; D014621:Vagina