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Archive » 2008 » 4 » | Archive » Medical field » Fields » Gynecology and Obstetrics »

Very Preterm Delivery: Prevention

 
Abstract:

This post is also available in: enEnglish slSlovenščina (Slovenian)

Background: Long term consequences for very preterm newborn may be serious and for this reason very preterm delivery (VPTD) has been recognised as one of the main problems of public health. Laypersons and even professionals are not aware of the fact that there are pos­sibilities for VPTD prevention and because of that long term handicap can also be prevented. There are many causes of preterm delivery and it is not likely that only one kind of manage­ment or one drug could prevent preterm delivery. Most women who deliver very preterm have no known risk factors. Possibilities for prevention: Screening tests should be used in all pregnant women. In the group of women with high risk, certain risk factors cannot be changed: previous preterm delivery and conisation, for example. Some risk factors can be eliminated before pregnancy, such as surgical correction of uterine anomalies. Examples of secondary prevention include administration of progesterone in those pregnant women who had pre­vious preterm deliveries or those after artificial reproductive techniques, cerclage when the cervix is short, treatment of vaginal infection early in pregnancy, need for psychological and social support. Even when preterm delivery is unavoidable, pregnancy can be prolonged with efficient tocolysis, so corticosteroids can be applied (tertiary prevention), and the pregnant woman should be transported to a centre with a neonatal intensive care unit, which will sig­nificantly improve the outcome for the newborn. Conclusions: Some risk factors can be eliminated or diminished, thus prolonging pregnancy when this is not harmful for the mother or the fetus. This also reduces long term consequences of preterm delivery. Existing knowledge regard­ing preterm delivery prevention must be applied. In the future, prevention of preterm delivery will be individual and specific.

Authors:
Novak Živa, Fabjan Vodušek Vesna, Steblovnik Lili

Keywords:
delivery, preterm - prevention and control

Cite as:
Med Razgl. 2008; 47: 355–65.

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