Zum Einfluß geburtshilflich-perinatologischer Maßnahmen auf die Mortalität und Frühmorbidität von Frühgeborenen der Gewichtsklasse 500 bis 1500 Gramm = Effect of obstetric-perinatal measures on mortality and early morbidity of premature infants weighing 500 to 1,500 grams

URN to cite this document:

urn:nbn:de:bvb:355-epub-208092 Copy

DOI to cite this document:

10.5283/epub.20809 Copy

Voigt, H. J. ; Lang, N. ; Segerer, Hugo ; Stehr, K.

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Date of publication of this fulltext: 16 May 2011 12:48

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Details

Item type:	Article
Journal or Publication Title:	Geburtshilfe und Frauenheilkunde
Publisher:	Thieme
Volume:	49
Number of Issue or Book Chapter:	8
Page Range:	pp. 720-727
Date:	1989
Institutions:	Medicine > Lehrstuhl für Kinder- und Jugendmedizin
Identification Number:	Value Type 2792706 PubMed ID 10.1055/s-2008-1036073 DOI
Classification:	Notation Type Asphyxia Neonatorum/mortality MESH Birth Weight MESH Cerebral Hemorrhage/mortality MESH Cesarean Section MESH Female MESH Fetal Growth Retardation/mortality MESH Fetal Membranes, Premature Rupture/mortality MESH Germany, West/epidemiology MESH Humans MESH Infant, Newborn MESH Infant, Premature, Diseases/mortality MESH Pregnancy MESH Prognosis MESH Retrospective Studies MESH Risk Factors MESH
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Unknown
Item ID:	20809

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Abstract

In a retrospective analysis of perinatal influencing factors in 186 premature newborns of the Department of Gynaecology of the University of Erlangen covering the period from 1982-1987 with birth weights between 500 and 1500 grams, the mortality and early morbidity were analysed, as characterised by cerebral haemorrhages, respiratory distress syndrome and infections insofar, as they had been ...

Abstract

In a retrospective analysis of perinatal influencing factors in 186 premature newborns of the Department of Gynaecology of the University of Erlangen covering the period from 1982-1987 with birth weights between 500 and 1500 grams, the mortality and early morbidity were analysed, as characterised by cerebral haemorrhages, respiratory distress syndrome and infections insofar, as they had been connected with the obstetrical approach and paediatric intensive-care treatment, 45 infants born in 1982/83 were compared with 141 infants, who had been subjected to a different treatment approach during 1984 to 1987. During the second period, there was a marked drop both in mortality and in the incidence of asphyxia-induced severe cerebral haemorrhage and of the respiratory distress syndrome. A shortened latency period after premature rupture of the amnion, and a more pronounced presence of a neonatologically experienced team of paediatricians were found to be significant obstetric liberal influencing factors in determining the need to perform Caesarean section. The triplication of the frequency of Caesarean section observed resulted in a 50% reduction in perinatal mortality and morbidity. Infants with pelvic presentation benefited most from the more liberal performance of Caesarean section, as did infants with vertex presentation. Shortening of the latency phase in premature rupture resulted in a marked reduction in infection morbidity and mortality. Therefore we conclude, that the frequently practised procrastination with the aim to await an improvement in lung maturity should be replaced by a more active obstetric management, avoiding both infection and birth trauma. Obstetric decisions should be based rather on prenatal estimation of weight than on the calculated gestational age. At present, the lowest birth weight associated with the expectation of a healthy life is considered to be 750 grams.

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