Affiliation:
1. Saratov State Medical University named after V.I. Razumovsky
Abstract
Introduction. Preterm birth (PR), complicated by premature rupture of the fetal membranes (PRPO), continues to be the focus of attention of obstetricians-gynecologists and neonatologists, due to high rates of perinatal morbidity and mortality.The purpose of the study: to identify the features of the course of puerperium in preterm birth with a long anhydrous interval.Material and methods. A single-stage cohort comparative study of the course and outcomes of PR complicated by PRPO and an anhydrous interval of more than 12 hours (group 1: n = 153) and spontaneous PR with an anhydrous interval of less than 12 hours (group 2: n = 408) has been conducted. Anamnestic data, peculiarities of pregnancy, childbirth, postpartum period, complications of puerperium and morbidity of newborns have been studied in detail.Results and discussion. Pregnancy in group 1 was significantly more likely to occur against the background of acute respiratory diseases (ARVI - 2 times), colpitis (2.6 times), more often complicated by threatening termination (1.3 times), the development of isthmic-cervical insufficiency (1.3 times) and chorioamnionitis (5.7 times). It has been found that in the group of patients with a long anhydrous interval, the risk of hyperthermia (2 times - up to 49.7%), subinvolution of the uterus (1.5 times - up to 25.5%), late hypotonic bleeding (13 times - up to 6.5%), endometritis (4 times - up to 3.9%) increased significantly in the postpartum period, increasing the probability of generalization of infection and hysterectomy to 1.3%.Conclusion. The results of the study once again have confirmed the negative impact of a long anhydrous interval on the incidence of newborns with PR. In addition, data have been obtained on an increased risk of purulent-septic infection in the puerperal period after PR, complicated by PRPO and a long anhydrous interval. All of the above indicates the need for further research in this area to develop a set of diagnostic and therapeutic measures to predict and prevent complications of puerperium during prolonged pregnancy complicated by PRPO.
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