АКУШЕРСКАЯ ТАКТИКА ПРИ НЕДОНОШЕННОЙ БЕРЕМЕННОСТИ, ОСЛОЖНЕННОЙ ПРЕЖДЕВРЕМЕННЫМ РАЗРЫВОМ ПЛОДНЫХ ОБОЛОЧЕК, СОСТОЯНИЕ ПЛОДА И НОВОРОЖДЕННОГО

Abstract

The present study is due to the high urgency of the problem of managing preterm labor initiated by premature rupture of the membranes. The purpose of this study was to analyze obstetric and neonatal outcomes during the prolongation of preterm pregnancy complicated by premature rupture of the membranes, and to assess the health status of newborns. Clinical observations were carried out on the basis of the State Health Institution "Clinical Perinatal Center of the Saratov Region".In 148 patients with a singleton pregnancy (the main observation group) at a period of 28-34 weeks, prenatal rupture of water occurred, while the pregnancy was prolonged to achieve greater morphological and functional maturity of the fetus. In 181 patients with a singleton pregnancy at the same gestational age, preterm labor occurred within the next 6-12 hours after prenatal rupture of water; these patients were included in the comparison group. Pregnancy in patients of the main group was prolonged by an average of 12.2±1.9 days (from 2 to 29 days). The paper presents the structure of indications for terminating the prolongation of preterm pregnancy with prenatal rupture of water, an analysis of the characteristics of the course of the birth act and the structure of indications for delivery by caesarean section in patients with premature pregnancy after a period of prolongation of gestation. A comparative analysis of the condition of 148 children born to patients of the main group and 181 newborns born to women of the comparison group showed the advantages of expectant management of patients with premature rupture of the membranes during preterm gestation. A decrease in the frequency of development and severity of respiratory disorders, the frequency of occurrence and degree of intraventricular hemorrhages in premature babies with the prolongation of a premature pregnancy complicated by prenatal rupture of water has been proven.