РLACENTA AND FETAL MEMBRANES WITH PREMATURE RUPTURE OF MEMBRANE AT TERM PREGNANCY

Abstract

Background. The frequency of premature rupture of the membranes (PROM) ranges from 2.7 to 17%. The main problem of the PROM is the increased risk of septic complications for both the mother and the fetus. Histopathological tests of placenta proves to be important for the diagnosis of choriomnionitis and in the prognosis of newborn’s intrauterine infection. The aim of the research is to reveal the most significant histological changes in the placenta and fetal membranes with PROM in full-term pregnancy as compared to the placental complex of patients with intact fetal membrane and onset of labor. Materials and methods. Our study included 88 pregnant women at 37-42 weeks of pregnancy. According to the inclusion and exclusion criteria, patients were divided into two groups. Primary group included 58 patients with term pregnancy who were diagnosed PROM and underwent caesarean section within 6 hours. Control group included 30 patients without PROM and uterine contractions with elective caesarean section. Exclusion criteria for both groups were specific viral and/or bacterial infections during the pregnancy, severe extragenital maternal pathology and complications of gestation (hypertension, preeclampsia, gestational diabetes, fetal anomalies), the presence of any signs of infection within the last 48 hours. A standard morphological study of the placenta and membranes was performed, the sections were stained with hematoxylin-eosin. Results. Newborn outcomes did not significantly differ in both groups, the physiological course of adaptation was present in 44 (75.86%) children in the primary group and 24 (80%) in the control group. Morphological signs of the inflammatory process in the fetal membranes and placenta were found in both the primary and control groups. However, diffuse inflammatory process, especially in combination with phlebitis and funiculitis was observed three times frequently in patients with PROM. Conclusion. We did not find a significant correlation between the severity of inflammatory changes in the placenta and clinical sings of the intrauterine infection in groups with PROM and intact fetal membrane. Inflammatory changes in the placenta and fetal membranes were equally observed in both groups, but the lesions were more diffuse and difficult in the group with PROM.