Erken doğum riski ve tahmini

Erken doğum insidansı giderek artmakta ve neonatal mortalite ve morbiditenin en önemli nedeni olmaya de-vam etmektedir. Erken doğumlar enfeksiyon, inflamas- yon, vasküler hastalıklar ve uterusun aşırı genişlemesi gibi birçok nedeni olan bir sendrom olarak kabul edil-mektedir. Multifaktöriyel etyolojisinden dolayı erken do- ğum riski olan kadınları belirlemek zordur. Erken doğum çoğu vakada enfeksiyonla ilgili patolojik bir süreç iken, normalde termde olması gereken fizyolojik sürecin erken aktivasyonu ile de olabilir. Önceden preterm doğum yap-mış olmak, sigara, periodontal hastalık, vücut kitle indeksinin düşük olması erken doğum için risk faktörle-ridir. İkinci trimesterde servikal uzunluğun kısalmış olması ve servikovajinal sıvıda fibronektin seviyesinin artması erken doğum tahmininde güvenilir yöntemlerdir. Her ne kadar erken doğumun sonuçlarını iyileştirici yön-temler olsa da erken doğumlarda hedef korunma olmalıdır.

Prediction of preterm delivery

The incidence of preterm birth is increasing and continues to be the leading cause of neonatal mortality and morbidity. Preterm births are regarded as a syndrome resulting from multiple causes, including infection or inflammation, vascular disease and uterine overdistension. The multifactorial aetiology of preterm birth make it difficult to identify the high risked women. Preterm birth is a pathological process, related in the majority of cases to infection, but also the early maturation of physiological processes, that normally occur at term. Risk factors for preterm births include a previous preterm birth, smoking, periodontal disease, low maternal body-mass index. A short cervical length in the second trimester and a raised cervical-vaginal fetal fibronectin concentration can accurately predict early birth. Prevention can be targeted, although effective measures that improve outcome are yet to be established.

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