COURSE AND OUTCOME OF PREGNANCY, OBSTETRIC TACTICS BY PRETERM RUPTURE OF MEMBRANES AT THE TERM OF 24-32 WEEKS

The birth of premature children is the cause of the increase in morbidity and perinatal mortality in the country, that is why it is necessary to carry out not only prognosis of premature births but also to correctly determine the tactics of managing patients with premature rupture of membranes. The objective of the study was to evaluate the course of pregnancy, perinatal outcomes, depending on the chosen tactics of managing women with premature discharge of amniotic fluid in the period of 24-32 weeks of pregnancy. Materials and methods: 46 patients were included in this study, 26 of them were the main group with premature rupture of membranes at a gestation period of 24-32 weeks, long anhydrous period (more than 48 hours), and 20 patients were included into the control group. The main criterion for inclusion in the control group was a spontaneous active onset of labor at a gestation period of 24-32 weeks, with an anhydrous period of less than 12 hours. Results: Patients of both groups were comparable in age, frequency of extragenital and gynecological pathology, main characteristics of menstrual function, parity and outcomes of pregnancies. In the presence of certain conditions in the main group, it was possible to apply expectant management tactics, which, on average, prolonged the pregnancy by 12.0 ± 2.3 days, which in 30.8% of cases was accompanied by the development of chorionamnionitis (p = 0.020), without interrelation with duration of anhydrous period and frequency of postpartum purulent-septic complications. It was found that perinatal outcomes, weight and condition of newborns at birth were much better in women in the main group. Conclusion: The reasonably chosen expectant management strategy for women with premature rupture of membranes at the gestational period of 24-32 weeks, subject to certain conditions, will improve perinatal outcomes without significantly increasing the incidence of infectious and inflammatory processes in the mother and newborn.

premature rupture of membranes, chorionamionitis, prematurity