T. Reimer, N. Ulfig, K. Friese
Antibiotics: Treatment of preterm labor
Our intention is to review recent data and provide recommendations
for the use of antibiotics in cases of preterm
labor or preterm premature rupture of the membranes
(pPROM). Various studies assessing antibiotics
as treatment for preterm labor demonstrate neonatal or
maternal benefits only in certain circumstances. Antibiotic
treatment should be given to patients with bacterial
vaginosis and Trichomonas vaginalis. Currently, antibiotics
should not be applied routinely to prolong pregnancy
in women with preterm labor and intact membranes.
However, antibiotic therapy should be given to
patients with pPROM to prolong pregnancies at 24 to
32 weeks' gestation. Our management of pPROM up
to 32 weeks' gestation includes use of corticosteroids,
antibiotic (extended spectrum penicillins) and tocolytic
treatment for preterm labor and pregnancy prolongation.
We consider expectant management previous to evidence
of intrauterine infection. In women with pPROM
at 32 to 34 weeks we found it beneficial to deliver 24
hours after administration of corticosteroids or, in cases
of intrauterine infection, immediately. Finally, we report
on our research work regarding fetal brain development
in preterm birth. Further studies will be necessary to
clarify the role of the interleukin-6/interleukin-6 receptor pathway in the development of intracerebral hemorrhage
frequently occuring in premature infants.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 27, 03/1999
Pages: 35 - 40
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