Prijevremeni porođaj

Abstract

Pretem labour continues to represent one of the most significant problem in perinatal medicine, primarily because of its high participation in the perinatal morbidity and mortality. Is defined as delivery prior to 37 weeks of gestation. The lower limit is usually taken 24 gestational weeks. The incidence in many countries around 7-10%. The causes of premature birth can be divided into: fetal, placental, uterine, maternal and other causes. Many microbiological and histopathological studies established that infection occurs in 25 to 40% of preterm labour. A preterm labour in most cases is result of preterm premature rupture of membranes. It occurs in about 40% of preterm births. Estrogen and progesterone play a major role in the endocrinology of pregnancy. Progesterone maintains the myometrium at rest, does not lead to creation of a "gap junction" inhibiting the formation and maturation of cervix. Estrogens contribute to the increase in contractility and excitability of the uterus as well as in induction of cervical ripening prior to the birth. The goal of tocolytic therapy is to stop the activity of the uterus and allow the extension of pregnancy and intrauterine fetal development, to improve perinatal outcome, without endangering the mother. Certain forms of tocolytic therapy can delay delivery for several days, allowing the full effect of corticosteroid therapy and transport the mother to a tertiary center. Inclusion corticosteroids to mother in the period 24-34 weeks of gestation leads to a reduction in perinatal morbidity and mortality.

Keywords: prematurelabour, premature rupture of membranes, corticosteroids.