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Infektionen und Frühgeburt

Infections and premature birth

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Zusammenfassung

Trotz der Fortschritte in der Behandlung und der neonatologischen Intensivmedizin ist die Frühgeburt immer noch die wichtigste Ursache der neonatalen Morbidität und Mortalität. Die Hypothese, dass die Aszension einer unteren Genitalinfektion zur Frühgeburt führt, wurde in zahlreichen Untersuchungen bestätigt. Sexuell übertragene Infektionen, u. a. mit Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, oder Syphilis können mit einer Frühgeburt und einer intrauterinen Infektion assoziiert sein. Auch andere genitale Erreger, z. B. Escherichia coli, wurden mit einer Chorioamnionitis und einer daraus resultierenden vorzeitigen Entbindung in Zusammenhang gebracht. Während eine bakterielle Vaginose, eine asymptomatische Bakteriurie, eine Trichomonadeninfektion und einige systemische maternalen Infektionen wichtige Risikofaktoren für eine Frühgeburt sind, scheint eine Besiedlung mit Mycoplasma hominis, Ureaplasma urealyticum oder Streptococcus agalactiae (GBS) kein prädisponierender Faktor zu sein. Auch heute ist Frühgeburtlichkeit, trotz jahrzehntelanger Forschung und zahlreicher Präventionsprogramme, immer noch ein gravierendes Problem. Die Entwicklung und Evaluierung zusätzlicher neuen Präventions- und Interventionsmaßnahmen sind für die Lösung dieses ernsten geburtshilflichen Problems unabdingbar..

Abstract

Despite the progress in treatment and neonatological intensive care medicine, premature births are still the most important cause of neonatal morbidity and mortality. The hypothesis that ascension of a lower genital tract infection leads to premature birth has been confirmed by many studies. Sexually transmitted diseases, including Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae and syphilis, can be associated with premature birth and a subsequent intrauterine infection. Other genital pathogens, e.g. Escherichia coli, have also been associated with chorioamnionitis and subsequent premature birth. While bacterial vaginosis, asymptomatic bacteriuria, trichomonas infections and some systemic maternal infections are important risk factors for premature birth, colonization by Mycoplasma hominis, Ureaplasma urealyticum or Streptococcus agalactiae (GBS) does not seem to be a predisposing factor. Even now premature birth is still a serious problem in obstetrics despite decades of research and many prevention programs. The development and evaluation of additional prevention and interventional measures are indispensable in order to control this serious obstetric problem.

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  1. Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde – Klinikum Innenstadt, Ludwig-Maximilians-Universität München, Maistr. 11, 80337, München, Deutschland

    I Mylonas & K. Friese

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  1. I Mylonas
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  2. K. Friese
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Correspondence to I Mylonas or K. Friese.

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Mylonas, I., Friese, K. Infektionen und Frühgeburt. Gynäkologe 45, 520–526 (2012). https://doi.org/10.1007/s00129-011-2934-0

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