Prevention
For most women, pregnancy is a wonderful event. Unfortunately, even with comprehensive care, still too many babies are born too early. Despite modern neonatal intensive care, some of the children suffer from major problems after their birth and in later life (these can be due to physical, visual or auditory problems or minor learning disabilities). Particularly at risk are children born well before their due day (before 32 weeks’ gestation) and / or very underweight (<1,500 g birth weight). Not every preterm child has such problems, but it has a markedly higher risk compared to children born at a much more mature stage (with 37 weeks’ gestation or more). Therefore, doctors and parents should do their utmost to avoid a preterm birth.
Some signs of a possibly threatening preterm birth can be recognized in time by specific observations and examinations, some of which the expectant mother can even carry out herself at home.
The best prevention is good medical supervision during pregnancy through regular participation in screenings and a health-supporting lifestyle. In the case of high psychosocial stress, competent support leading to a reduction of the burdening circumstances can contribute to a decrease of the preterm birth rate.
If preterm labour pains are detected or preterm birth is expected because of other causes, the child's lung can be "matured" by giving the mother cortisone one to two days before the expected birth.
Preterm contractions can often be suppressed by specific medication (tocolysis) and by being confined to the bed. This gains time for the lung maturity treatment and often achieves a pregnancy prolongation with a better prognosis for the child. In this manner the pregnancy can be extended from 24 to 26 weeks of gestation, which already improves its survival chances by 25% !
Ascending vaginal infections as a major cause of preterm birth.
One of the most common preventable causes of preterm birth is the often unnoticed increase in pathogenic germs in the vagina. Normally a high concentration of lactic acid -forming bacteria in the vagina prevent the proliferation of pathogenic bacteria. If the number of lactic acid-forming bacteria decreases for various reasons and so disrupts their protective function, it can lead to a reduction in acidity of the vagina and hence to an increase in pH value (high pH = low acidity). This might result in a massive proliferation of pathogenic bacteria. When these bacteria ascend into the uterus, preterm labour or preterm rupture of the membranes (PROM) can be caused and in the end lead to preterm birth, perhaps resulting in an infection of the child. The risk of preterm birth can often be lowered by early recognition of the reduced acidity of vaginal fluid and a treatment of the causes.
For further information please visit the following websites:
BabyCare: www.baby-care.de
Erich Saling-Institute of Perinatal Medicine: www.saling-institut.de
