Basic aspects of prematurity prevention and results achieved by a suitable, simple program

An urgent task for modern obstetrics is to reduce the number of unwanted ve ry early prematures. Long-term impairments of these infants still occur too frequently. Ascending genital infections, particularly before 32 gestation al weeks, are the most significant cause of prematurity. The best chance of preventing early prematurity is to employ a prophylactic screening program , preferably including self-pH-measurement by all pregnant patients and pay ing attention to all other important risk factors. The results of this "Pre natal Care Self-Examination" program are encouraging. The rate of Very smal l prematures, with a birth weight of less than 1,500 g, in all 1,120 multig ravidae who have taken part in this program is clearly lower, at 1.3 %, tha n in immediate previous pregnancies when it was 7.8 %. The rate of extremel y small infants of less than 1,000 g amounted to 0.9 %, compared with 3.9 % in previous pregnancies. Results from a prospective study recently present ed confirm in a convincing way what can be achieved in an entire city. In E rfurt, with 208,000 inhabitants and about 1,500 deliveries per year, all in the one maternity department in this city; 16 practitioners taking care of the pregnant patients, i.e. nearby one half of them in Erfurt, motivated, their patients to take part in our prematurity prevention program with its "Prenatal Care Self-Examination", where the patients themselves measured th eir vaginal pH twice a week. The results are very interesting. In the group of 1,842 patients without prenatal self-examination activity, the frequenc y of very early prematures - i.e. less than 32 weeks gest. was 3.3 % (n = 6 1). In the group of 314 patients who performed prenatal self-examinations, the corresponding frequency uas only 0.3 % (n=1). This is an eleven-fold, a nd significantly lower rate. On account of such positive results, a definitive step has been made with r egard to practicability and efficiency of prevention of very early prematur e birth.