Author/Editor		Pirih, Alenka; Pajtler, Ana
Title		Dajanje kortikosteroidov ženskam v nosečnostih, ki se končajo s prezgodnjim porodom
Translated title		Administration of corticosteroids to women during pregnancy that ends in preterm parturition
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 44, št. 4
Publication year		2005
Volume		str. 409-24
Language		slo
Abstract		Preterm delivery is associated with neonatal mortality, severe neonatal morbidity with long-term consequences, and disturbances in neurologic development. However, when prevention of preterm delivery is impossible, preventative administration of corticosteroids at least 24 hours prior to preterm delivery has been proved to reduce neonatal mortality and morbidity. Our aim was to find out why only 38.6% of children born between 28. 0/7 and 32. 6/7 weeks of gestation at the Ljubljana Maternity Hospital during the year 2000 received antenatal corticosteroids. An attempt was made to evaluate the standard values (sensitivity, specificity, and positive and negative predictive values) of the test that detects the phosphorylated form of insulin growth factor binding protein type 1 (phIGFBP-1) in the cervical fluid for prediction of preterm delivery, and to increase its usage. Our aim was also to draw up recommendations on how to increase the number of pregnant women with a high risk of preterm delivery that are given corticosteroids. It was expected that over 38.6% of pregnant women who delivered their babies between 28. 0/7 and 32. 6/7 weeks of gestation would have been treated with corticosteroids. However, this was not indicated in the delivery protocol. The desire was to evaluate standard values of the test for detecting phIGFBP-1. It is expected that our recomendations will increase the number of pregnant women at high risk of preterm delivery to be treated with corticosteroids. In the retrospective part, perinatal data were analyzed on women who delivered between 22. 0/7 and 33. 6/7 week of gestation in the year 2000 at the Ljubljana Maternity Hospital. It was analyzed how many were given corticosteroids, whether they received them at least 24 hours prior to delivery and whether this was marked in delivery protocol. (Abstract truncated at 2000 characters)
Summary		Prezgodnji porod z rojstvom nedonošenčka je povezan z neonatalno umrljivostjo, neonatalno obolevnostjo z dolgotrajnimi zdravstvenimi posledicami in motnjami v nevrološkem razvoju. Dokazano je, da s pravočasnim dajanjem kortikosteroidov vsaj 24 ur pred prezgodnjim porodom zmanjšamo pojav zapletov. V nalogi smo želeli ugotoviti, zakaj je samo 38,6% prezgodaj rojenih otrok z gestacijsko starostjo od 28. 0/7 (28 tednov in 0 dni) do 32. 6/7 tedna v Porodnišnici Ljubljana v letu 2000 dobilo kortikosteroide. Oceniti smo želeli standardne vrednosti (občutljivost, specifičnost, pozitivno in negativno napovedano vrednost) testa za določanje fosforilirane oblike vezavnega proteina za inzulin podoben rastni dejavnik tipa 1 (phIGFBP-1) iz cervikalnega izločka v napovedi prezgodnjega poroda. Prav tako smo želeli povečati njegovo uporabo ter priporočiti ukrepe za povečano dejanje kortikosteroidov nosečnicam z visokim tveganjem za prezgodnji porod. Pričakovali smo, da je več kot 38,6% nosečnic, ki so rodile prezgodaj (od 28. 0/7 do 32. 6/7 tedna gestacijske starosti), dobilo kortikosteroide, vendar to ni bilo zabeleženo v porodnem zapisniku. Želeli smo določiti orientacijske standardne vrednosti testa za določanje phIGFBP-1 za porod v dveh tednih po testu. V retrospektivnem delu naloge smo pregledali popise porodnic, ki so rodile prezgodaj (od 22. 0/7 do 33. 6/7 tedna gestacijske starosti) v letu 2000 v Porodnišnici Ljubljana. V popisih bivanja v bolnišnici smo pregledali, koliko jih je dobilo kortikosteroide, ali so jih dobile v več kot 24 urah pred porodom in ali je bilo to pravilno zabeleženo v porodnem zapisniku. V prospektivnem delu smo nosečnicam, ki so bile sprejete v bolnišnico in/ali ambulantno pregledane na Kliničnem oddelku za perinatologijo Ginekološke klinike Kliničnega centra v Ljubljani v obdobju med 12.3.2002 in 13.2.2003, določili phIGFBP-1. (Izvleček prekinjen pri 2000 znakih).
Descriptors		LABOR, PREMATURE RISK FACTORS ADRENAL CORTEX HORMONES INSULIN-LIKE GROWTH-FACTOR BINDING PROTEIN 1 GESTATIONAL AGE