Udo B Hoyme
Ilm-Kreis-Kliniken, Germany
Biography
Udo B Hoyme has graduated from University of Hamburg, Germany in 1973. In 1993 he became the Chairman of the Department of Obstetrics and Gynaecology, Medical School Erfurt and later HELIOS Kliniken. In 2013, he retired as Head of the Department of Obstetrics and Gynaecology, St. Georg-Klinikum Eisenach. He is working as Senior Consultant in Ilm-Kreis-Kliniken, Arnstadt, Germany. He has published more than 300 papers and he is an editor and reviewer of several international journals.
Abstract
In the initial so-called Erfurt prematurity trial almost 20 years ago, based on a simple screening strategy with intravaginal pH self-measurements (cut off pH>4.5), adequate physician based medical diagnosis and immediate antimicrobial therapy of genital infection, 0.3% of the neonates <32+0 weeks were seen in an intervention group vs. 3.3% (p<0.01, n=2722) in the control group. In the larger state wide Thuringia campaign limited to the year 2000 the figures were 0.94% vs. 1.36% (p<0.01, n=16,276). The rate of newborns <1000 g was reduced to 0.38%, the lowest incidence ever seen in any of the German states, however, after discontinuation of the campaign for several reasons the preterm birth rates mounted in the state to the same level as prior to the program. As long as we do not have alternative safe, simple and cheap methods, intravaginal pH-measurement is the best option to detect women at risk and in need for specific diagnostic assessment followed by efficient medical treatment, e.g. lactobacilli, e.g. in case of bacterial vaginosis preferably by clindamycin before week 23. The practical cheap regime should be generally implicated as an indicated step of optimizing and rationalizing the national health care system. Good news for at least 18,000 pregnant women annually: The government of our state of Thuringia has decided in 2016 to re-establish a pH self-care screening program similar to that of the year 2000. Beginning at zero almost one year after initiation >80% of pregnant women in the state have their vaginal pH measured in December 2017. First pregnancy outcome parameters will be available by mid of 2018.