[Clinical results of perfusion-oriented therapy of threatened premature labor].

The aim of this study is to show whether a perfusion-oriented treatment of preterm labour under routine conditions has a positive impact on the outcome of these risk pregnancies and is able to reduce neonatal morbidity. We compared a group of 143 cases of preterm labour under tocolytic therapy to a group of 164 cases with comparable conditions and dopplersonographic measurements of the uteroplacental and fetal perfusion. Depending on the resistance- and pulsatility index of both uterine arteries, umbilical artery, fetal descending aorta and fetal middle cerebral artery an additional therapy (oxygen administration or transcutaneous dorsal nerve stimulation (TENS) was performed. 53 cases with pathologic uterine perfusion underwent in addition to tocolytic therapy a treatment with TENS. 18 cases with pathologic fetal perfusion were treated with oxygen administration. With comparable conditions at admission the group with a perfusion-oriented treatment has a significantly higher gestational age at delivery and prolongation of gestation. The percentage of preterm infants with a gestational age at delivery < 31 weeks is lower. Particularly cases with a low gestational age at the onset of preterm labour prior to 30 weeks of gestation do benefit. The comparison regarding the percentage of neonatal diagnosis and resulting methods of therapy, especially initial resuscication and CPAP, indicates a positive impact on fetal outcome of a perfusion-oriented treatment in pregnancies with preterm labour.