CONNECTION OF PREMATURE RUPTURE OF FETAL MEMBRANES WITH INTRAUTERINE AND MATERNAL INFECTIONS
DOI:
https://doi.org/10.11603/1681-2727.2020.1.11107Keywords:
preterm pregnancy, premature rupture of fetal membranes, intrauterine and maternal infectionsAbstract
The purpose of the work is to analyze the current scientific information about the connection of premature rupture of fetal membranes (PRFM) with intrauterine and maternal infections and the features of premature pregnancy complicated by PRFM.
PRFM complicates up to 8 % of all pregnancies and is the main cause of the development of spontaneous preterm birth (PB) of 30–51 %, and in the term when PB begins before 26 weeks of pregnancy, the proportion of PRFM reaches 90–92 %.
A premature birth defect does not always lead to the development of regular labor, anhydrous period can last days and months, and this usually leads to a pathological birth, extremely adverse effect on the maternal organism and the fetus.
Given that children born before 34 weeks of age, pulmonary hypoplasia can lead to neonatal mortality, a waiting tactic in this term is justified, and after 34 weeks a prolonged waiting tactic (12–24 h or more) is not shown. In case of PB, which is complicated by PRFM, it is necessary to assess the risks: 1) the risk of waiting tactics (prolongation of pregnancy); 2) the risk of actively waiting tactics (pre-induction, induction of childbirth); 3) the risk of active tactics (operative delivery by caesarean section, as well as at the same time fetus risks: prematurity, neonatal sepsis, pulmonary hypoplasia, respiratory distress syndrome, cord compression, maternal risks, premature development chorioamnionitis, postpartum endometritis and sepsis.
The development of neonatal sepsis in PRPO up to 34 weeks of gestation is statistically significantly more frequent in women with a positive polymerase-chain response to infectious agents such as Ureaplasma, Mycoplasma hominis, Chlamydia trachomatis and with clinical signs of chorioamnionitis.
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