Features of the course of puerperium in preterm birth with a long anhydrous interval

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.