A labor (contractions that lead to cervical changes) that begins before 37 weeks is called prematurely. Risk factors include premature rupture of membranes, uterine abnormalities, infection, cervical insufficiency, previous preterm delivery, multiple pregnancy and placental abnormalities. The diagnosis is made clinically. The causes are identified and treated if possible. Treatment usually includes bed rest, Tocolytics (with continuing labor), corticosteroids (at a gestational age <34 weeks) and possibly magnesium sulfate (at a gestational age of <32 weeks). When not present negative anovaginalen bacteriological examination findings streptococcal effective antibiotics are to be applied.

Premature labor can be triggered by

A labor (contractions that lead to cervical changes) that begins before 37 weeks is called prematurely. Risk factors include premature rupture of membranes, uterine abnormalities, infection, cervical insufficiency, previous preterm delivery, multiple pregnancy and placental abnormalities. The diagnosis is made clinically. The causes are identified and treated if possible. Treatment usually includes bed rest, Tocolytics (with continuing labor), corticosteroids (at a gestational age <34 weeks) and possibly magnesium sulfate (at a gestational age of <32 weeks). When not present negative anovaginalen bacteriological examination findings streptococcal effective antibiotics are to be applied. Premature labor can be triggered by Premature rupture chorioamnionitis Another ascending uterine infection (generally by group B streptococci) multiple pregnancy fetal or placental abnormalities uterine abnormalities pyelonephritis Some STDs ( "sexually transmitted diseases" STDs) One reason may not be obvious. Preceding premature birth and cervical incompetence increase the risk. Premature labor can increase the risk of neonatal intraventricular hemorrhage; intraventricular hemorrhage may have a disability neurodevelomentale result have (z. B. cerebral palsy). Diagnosis Clinical Investigation The diagnosis of preterm labor is based on signs of labor and the length of pregnancy. Anovaginale cultures of group B streptococci are applied, and a suitable prophylaxis is initiated. Usually Urinalysis and culture are used to test for cystitis and pyelonephritis. A bacteriological swab is taken to test for sexually transmitted diseases if this is necessary due to the clinical examination findings. In most women with the diagnosis preterm labor there will be no giving birth. Treatment Antibiotics against group B streptococci, depending on the result of the culture anovaginalen Tocolytics corticosteroids at <34 weeks of magnesium sulfate at <34 weeks First bed rest and hydration are often prescribed. Antibiotics As long as negative anovaginale cultures stand, streptococcus B-effective drugs are used. You can choose from the following: In women without penicillin allergy: penicillin G 5 million IU i.v., then 2.5 million I.U. every 4 hours or ampicillin 2 g i.v. followed by 1 g every 4 hours in women with penicillin allergy, but low risk for anaphylaxis (eg, maculopapular rash on a previous application.): Cefazolin 2g iv followed by 1 g every 8 hours in women with penicillin allergy and increased risk of anaphylaxis (e.g., bronchospasm, angioedema or hypotension in previous application, in particular within 30 minutes after exposure.): Clindamycin 900 mg i.v. every 8 hours or erythromycin 500 mg i.v. every 6 hours at effectiveness in the anovaginalen cultures; with documented resistance of cultures or missing data location Vancomycin 1 g i.v. every 12 hours Tocolytics fails to open the cervix, can Tocolytics (medications that uterine contractions bring to cessation) the birth normally to delay for at least 48 hours, so corticosteroids to reduce fetal risk can be given. Tocolytics include magnesium sulfate, a calcium antagonist, prostaglandin inhibitors No tocolytic provides a unique means of first choice; the choice should be made individually, to minimize the adverse effects. Magnesium sulfate is often used and is well tolerated in general. Prostaglandin inhibitors may cause temporary Oligohydramnios. They are contraindicated after 32 weeks, as they can lead to premature narrowing or a closure of the ductus arteriosus. iv Magnesium sulfate should be considered in pregnancies <32 weeks of gestation into account. In utero exposure to the drug's risk of serious neurological disorders (eg. As a result of intraventricular hemorrhage), including cerebral palsy appears in newborns to reduzieren.Corticosteroide If the fetus <34 weeks be administered to women corticosteroids, unless the delivery is imminent. One of the following may be performed: betamethasone 12 mg i. m. every 24 h for 2 doses 6 mg dexamethasone i.m. every 12 h accelerate These corticosteroids for 4 doses fetal lung maturation and reduce the risk of neonatal respiratory distress syndrome, intracranial hemorrhage or loss of life Ausgangs.Gestagene A progestin may be recommended for women with preterm labor during future pregnancies to reduce the risk of recurrence , This treatment is started in the second quarter and continued until shortly before the birth. Summary It should be applied anovaginale cultures of group B streptococci and other cultures more to the basis of the clinic suspected infections could trigger premature labor (z. B. pyelonephritis, sexually transmitted diseases) to test. It is, depending on the result of the culture treated with streptococcal B-effective antibiotics. If the cervix extended a tocolysis with be pulled in ? 32 weeks with a prostaglandin inhibitor into consideration magnesium sulfate, a calcium channel blocker, or should. A corticosteroid is added to the <34 weeks. Pull magnesium sulfate into consideration if the fetus is <32 weeks of gestation. In future pregnancies a progestin for the prevention of recurrence should be considered.

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