Efferent therapy in pregnant women with the threat of very early premature birth with premature effusion of amniotic fluid. Two clinical observations

It is known from the literature that premature amniotic fluid expulsion in 22 weeks – 27 weeks 6 days gestation is very dangerous, as it is accompanied by high morbidity and mortality in newborn infants.

Clinical observation. This article presents the results of observing two women with premature amniotic fluid expulsion at 22 and 24 weeks’ gestation, respectively. In the first case, the woman was immediately admitted to the perinatal center; in the second observation, she was admitted after 3.5 weeks of treatment at another institution. In both cases, pregnant women had manifestations of oligo and endotoxemia, a protective inflammatory response in the mother-placental-fetal system (more pronounced in the second observation) against a background of urogenital infection. In the course of complex treatment, the patients underwent detoxification, of efferent therapy in the form of repeated consecutive sessions of plasmapheresis, hemosorption (one operation each), external photomodification of blood with ultraviolet, laser beams with prolongation of pregnancy by 10 and 8 weeks. The deliveries in both cases were operative with live babies with body weight of 1600 g and 1840 g, respectively. In the first case the infant did not need intensive care, was breastfed, in the second observation the newborn received active respiratory support for 9 days, in the dynamics his condition normalized. No septic complications in mothers and fetuses were observed.

The concluding efferent therapy in course of therapy were effected by prolongating of pregnancy with of good the results for mothers and them of fetus.