Koucký M, Germanová A, Hájek Z, Parízek A, Kalousová M, Kopecký P
Charles University in Prague, First Faculty of Medicine and General University Hospital, Department of Gynaecology and Obstetrics, Prague, Czech Republic.
Prague Med Rep. 2009;110(4):269-77.
New knowledge of the pathophysiology of premature birth enables us to introduce new approaches in prenatal care as well as the management of premature delivery. These apply for the patients with subclinical risk factors, particularly with thrombophilias, chronic infections or other latent chronic infections. The peri- and pre-conceptional dispensarisation of these women might help reduce the development of premature delivery. Secondary prevention with the administration of gestagens is highly important for women with anamnestic or existing risk of premature delivery. During the underlying premature delivery, it is advisable to re-evaluate the significance of the administration of antibiotics and tocolytics as well as timing of corticoid dosage in the induction of foetal lung maturity. Using new diagnostic and therapeutic methods, the aim of present premature delivery management is to prolong the duration of pregnancy to the maximum with the lowest risk of the development of foetal inflammatory response possible and, therefore, with a low risk of long-term handicaps in children.
早产病理生理学的新知识使我们能够在产前护理以及早产管理方面引入新方法。这些方法适用于具有亚临床风险因素的患者，特别是患有血栓形成倾向、慢性感染或其他潜伏性慢性感染的患者。这些女性在围孕期和孕前进行健康管理可能有助于减少早产的发生。对于有早产既往史或现有早产风险的女性，使用孕激素进行二级预防非常重要。在潜在的早产过程中，建议重新评估抗生素和宫缩抑制剂的使用意义以及在诱导胎儿肺成熟时皮质类固醇给药的时机。通过使用新的诊断和治疗方法，目前早产管理的目标是尽可能延长孕期，同时将胎儿炎症反应发生的风险降至最低，从而降低儿童长期残疾的风险。
