TACTICS OF THE MANAGEMENT OF PREMATURE DELIVERIES: TO WHAT PATIENTS TOCOLYSIS IS INDICATED AND SHOULD HELP

Abstract

The urgency of the problem of premature birth (PB) is caused due to a high early neonatal mortality rate among preterm infants (60-70%), the prevalence rate of neurologic diseases (up to 50%), including infantile cerebral palsy, visual, hearing disorders and other chronic diseases. The frequency of PB in the population varies between 7 and 15%, however, despite the great possibilities of modern midwifery, there is a pronounced tendency to increase this index. The analysis of the lethality of prematurity in perinatal centers of the Department of Healthcare of the city of Moscow in 2016, obviously shows the main part of it to be presented by with extremely low body weight infants. Thus, preventing the premature birth, especially at the term of 24-27 weeks, is an important task for medicine all over the world. Atosiban (tractocile) - a competitive antagonist of human oxytocin at the level of receptors, the first drug designed to inhibit labor. For the purpose of tocolysis 54 women at the 26-34 weeks of the gestation period got the treatment with tractocile. Tocolysis with atosiban was effective in 90.7% of cases with a slight shortening of the cervix (no more than 5 mm) regardless of the gestational age. The introduction of the drug leads to a decrease in the intensity and jugulating pain syndrome in the first 6 hours following the administration, which confirms its effectiveness and allows increase chances of a favorable outcome of pregnancy. The absence of the infection of the kidneys and urinary tracts during pregnancy and genital tract, the onset of tocolysis up to the 31st week of the gestation and the absence of ischemic-cervical insufficiency, which indicates the need for quality and rational management of pregnancy at the outpatient stage are most important factors for the success of tocolysis and prolongation of pregnancy for more than 48 hours.