Hoyme U B, Möller U, Saling E
Klinik für Frauenheilkunde und Geburtshilfe, HELIOS Klinikum Erfurt.
Zentralbl Gynakol. 2003 Mar-Apr;125(3-4):107-11. doi: 10.1055/s-2003-41867.
In two prospective investigations the effectiveness of the self- care program for prematurity prevention, developed by Saling, was investigated. Pregnant women in Erfurt have been offered to perform self-measurements of their vaginal pH by means of test gloves (Careplan VpH) twice a week. The women were instructed to see their physician immediately, if abnormal values (pH > or = 4.7) or other risk factors were present. 73 out of 381 women in the intervention group have been identified as risk cases. 58 of them were treated with a lactobacillus preparation, and 24 with clindamycin cream for bacterial vaginosis, 3 patients refused to have any therapy. In this study the prematurity rate was 8.1 % in the self-measurement/intervention group vs. 12.3 % in the control group (N=2 341, P < 0.05); 0.3 % vs. 3.3 % of the neonates belonged to the group of early prematures with a gestational age of < 32 + 0 weeks (P < 0.01). PROM was registered in 22.8 % vs. 30.8 % (P < 0.001) respectively. Starting March 1, 2000 a similar statewide pH-screening program was initiated in Thuringia. According to the study design a significant decrease of prematurity was hypothetically expected for the second half of the year 2000. In Erfurt an overall decrease of prematurity from 7.68 to 6.81 % and a reduction of cases < 32 + 0 weeks from 3.22 to 2.39 % was observed (N=1,600). Data from 16,276 women are available for the state of Thuringia. On this basis a significant reduction of early prematurity from 1.58 to 0.99 % was seen respectively (P < 0.001). Comparing low birthweights a significant reduction of cases was achieved as well in all groups. On the basis of the data obtained we recommend the extension of the campaign in the whole of Germany.
在两项前瞻性研究中,对萨林开发的预防早产自我护理计划的有效性进行了调查。爱尔福特的孕妇被要求每周两次使用测试手套(Careplan VpH)自行测量阴道pH值。如果出现异常值(pH≥4.7)或其他风险因素,这些女性会被指示立即就医。干预组的381名女性中有73人被确定为风险病例。其中58人接受了乳酸杆菌制剂治疗,24人因细菌性阴道病接受了克林霉素乳膏治疗,3名患者拒绝接受任何治疗。在这项研究中,自我测量/干预组的早产率为8.1%,而对照组为12.3%(N = 2341,P < 0.05);孕周<32 + 0周的早期早产新生儿比例分别为0.3%和3.3%(P < 0.01)。胎膜早破的发生率分别为22.8%和30.8%(P < 0.001)。从2000年3月1日起,图林根州启动了一项类似的全州pH值筛查计划。根据研究设计,预计2000年下半年早产率将显著下降。在爱尔福特,观察到早产率从7.68%总体下降到6.81%,孕周<32 + 0周的病例从3.22%减少到2.39%(N = 1600)。图林根州有16276名女性的数据。在此基础上,早期早产率分别从1.58%显著降低到0.99%(P < 0.001)。比较低体重儿情况,所有组的病例数也都显著减少。根据获得的数据,我们建议在全德国推广这项活动。