Leitung der Frühgeburt

Preterm birth affects about 9% of deliveries in Germany and poses an interdisciplinary challenge. Midwifes, obstetricians, pediatricians, and anesthesiologists are equally involved in the management. Efficient communication and internal interdisciplinary guidelines are essential to optimize perinatal and long-term outcome of the fetus. The initial decision regarding neonatal outcome is essentially made pre-clinically, since referral of the patient to a proper perinatal center significantly reduces morbidity and mortality. This article describes the coordination of spontaneous and medically indicated preterm birth between 24 and 37 weeks of gestation, as well as the related decision-making processes. The focus is on perinatal management. Procedures including preparation (tocolysis, interdisciplinary communication, antenatal corticosteroids, neuroprotection, antibiotics), choice of the mode of delivery, and monitoring, as well as the management of actual labor and neonatal care in the first golden hour will be discussed.