Jacobsson Bo, Saltvedt Sissel, Wikström Anna-Karin, Morken Nils-Halvdan, Leijonhufvud Åsa, Hagberg Henrik
Institutionen för Kliniska Vetenskaper - Avdelningen för Obstetrik och Gynekologi Göteborg, Sweden Institutionen för Kliniska Vetenskaper - Avdelningen för Obstetrik och Gynekologi Göteborg, Sweden.
Karolinska Universitetssjukhuset - PO Graviditet och Förlossning Stockholm, Sweden Karolinska Universitetssjukhuset - PO Graviditet och Förlossning Stockholm, Sweden.
Lakartidningen. 2019 Oct 8;116:FSST.
Due to a low level of understanding of mechanisms involved in spontaneous preterm delivery there is a lack of reliable biomarkers. Existing biomarkers have a low positive predictive value but a high negative predictive value. Use of tests with high negative predictive value will reduce unnecessary interventions and hospitalization of women with threatening preterm delivery. When given to the right pregnant women, antenatal corticosteroid treatment are still the most important obstetrical intervention and reduces both neonatal mortality and short- and long-term morbidity.Several ongoing national Swedish multicenter studies may increase the understanding of the roles of cervical length, preeclampsia screening and magnesium sulfate dosage in the context of preterm delivery in a Nordic setting. Major development has been achieved in prediction and prevention of preterm preeclampsia at the cost of a 10% screen positive rate.
由于对自然早产所涉及机制的了解程度较低,缺乏可靠的生物标志物。现有的生物标志物阳性预测值低,但阴性预测值高。使用具有高阴性预测值的检测方法将减少对有早产风险的妇女进行不必要的干预和住院治疗。对于合适的孕妇,产前皮质类固醇治疗仍然是最重要的产科干预措施,可降低新生儿死亡率以及短期和长期发病率。瑞典正在进行的几项全国性多中心研究可能会增进对北欧环境下早产情况下宫颈长度、子痫前期筛查和硫酸镁剂量作用的理解。在预测和预防早产子痫前期方面已取得重大进展,但筛查阳性率为10%。