Supervisors info:
Σοφία Καλανταρίδου, Καθηγήτρια, Ιατρική Σχολή,ΕΚΠΑ
Νικόλαος Ευαγγελινάκης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Παπαϊωάννου, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Despite the remarkable advancements in modern obstetrics, the problem of premature birth remains unresolved with its impact presenting an upward trend. Prematurity is one of the leading causes of neonatal mortality and childhood morbidity worldwide. Infants with very low birth weight are at risk of significant morbidity from respiratory distress syndrome, necrotic enterocolitis and intraventricular hemorrhage, while many preterm infants are burdened by significant long-term neurological dysfunction, chronic lung problems and eye disorders.
Regarding the pathophysiology of preterm birth, some possible mechanisms include the disruption of maternal-fetal immune tolerance, uterine hyperdistension, placental abruption, and the activation of the immune response to inflammation. However, the underlying mechanism of preterm birth remains unclear.
Common risk factors for preterm birth include maternal age and race, smoking, extensive use of RTA, but also maternal infections and chronic conditions such as diabetes and hypertension. Moreover, it has been suggested the genetic predisposition may be the causal basis of preterm birth.
In terms of treatment, primary prevention should aim to eliminate modifiable risk factors (eg smoking cessation, avoiding occupational stress and reducing multiple pregnancies). At present, there is insufficient evidence to demonstrate the effectiveness of antibiotics in the treatment of maternal infection. In addition, measuring the length of the cervix can be an important method of identifying patients at high risk of preterm birth and selecting the appropriate method of secondary prevention, namely progesterone administration, cerclage or arabin pessary. In case of labour, short-term tocolysis may provide the time necessaryto achieve the action of corticosteroids or to admit the pregnant woman to a hospital with the necessary facilities for intensive care of newborns.
Keywords:
Premature birth, Premature rupture of membranes , Cerclage, Arabin pessary
