Journal
GEBURTSHILFE UND FRAUENHEILKUNDE
Volume 73, Issue 12, Pages 1218-1227Publisher
GEORG THIEME VERLAG KG
DOI: 10.1055/s-0033-1360195
Keywords
premature rupture of membranes; impending preterm birth; premature uterine contractions; antibiosis for impending preterm birth
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In Germany almost 10% of children are born before the end of 37th week of gestation. In at least one quarter of these cases, ascending infection of the vagina plays a causative role, particularly during the early weeks of gestation. If, in addition to the decidua, the amniotic membrane, amniotic fluid and the umbilical cord are also affected, infection not only triggers uterine contractions and premature rupture of membranes but also initiates a systemic inflammatory reaction on the part of the fetus, which can increase neonatal morbidity. Numerous studies and meta-analyses have found that antibiotic therapy prolongs pregnancy and reduces neonatal morbidity. No general benefit of antibiotic treatment was found for premature uterine contractions. But it is conceivable that a subgroup of pregnant women would benefit from antibiotic treatment. It is important to identify this subgroup of women and offer them targeted treatment. This overview summarizes the current body of evidence on antibiotic treatment for impending preterm birth and the effect on neonatal outcomes.
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