PERINATAL CONSEQUENCES OF MISCARRIAGES ATTHE PREMATURE RUPTUREOF MEMBRANES
DOI:
https://doi.org/10.11603/24116-4944.2008.1.9500Keywords:
miscarriages, premature rupture of membranes, congenital infectionAbstract
Was made examination of 46 pregnant with premature rupture of membraines (PROM), which gave birth living children in a term 22-35 weeks of pregnancy for estimation of influencing of duration of waterless interval on the state of newborns. The factors of risk of the PROM were the burdened obstetric anamnesis in 58,7 % pregnant (premature births, miscarriage, spontaneous delivery, stillbirth), burdened gynaecological anamnesis in 63,1 %. Had concomitant extragenital pathology 56,5 % pregnant. The diseases of infectious character prevailed and in 2,1 % women there was HIV-infection.At bacteriological research of vaginal microflora and cervical canal opportunistic gram-negative microflora prevailed, as Enterococcus, Clebsiella, Proteus vulgaris in 60,8 % cases, candidosis - 39,2 %, bacterial vaginosis - in 34,7 %, trichomoniasis - in 10,8 %. Aggregation of a few types of microflora could be the reason of ascending infection and PROM.Gave birth through the vaginal were 86,9 % pregnant, cesarean section was made by the obstetric indication 13,1 %. Died 9 newborn from an congenital infection, specific for a perinatal period, lethality made 19,6 %. Frequency of lethal cases depended on the term of pregnancy, weight of newborn and duration of waterless interval. Thus, in the group of newborn weight 500-999 g lethality was 100 % at middle duration of the waterless interval 86,4±58,2 hours, in a gravimetric category to a 1500 g lethality made 25 % at middle duration of the waterless interval 280,8 ± 198,2 hours, in a gravimetric category to a 2000 g lethality was the lowest and made 2 cases only - 11,8 % at middle duration of the waterless interval 480,2±195,6. In a gravimetric category to 2500 g lethal cases were not, in spite of most duration of waterless interval (182,7±124,5). Thus, in the case of PDAF, the term of prolongation of pregnancy must depend on the term of pregnancy, putative weight of newborn, clinical state of mother and fetus, appearance of symptoms of infection. This question remains finally unsolved on a modern stage.
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