• Differentiated tactics of pregnancy in women with premature rupture of membranes
en To content Full text of article

Differentiated tactics of pregnancy in women with premature rupture of membranes

HEALTH OF WOMAN. 2020.1(147): 42–51; doi 10.15574/HW.2020.147.42
Z.M. Dubossarska, Yu.O. Dubossarska, Ye.O. Puzii
SІ «Dnipropetrovsk medical Academy Ministry of health of Ukraine»

The problem of premature rupture of membranes (PROM) is unfortunately still relevant in modern obstetrics and perinatology, especially in preterm pregnancy, and leads to 20% of all cases of perinatal loss. Among the possible causes, a lot of attention has recently been paid to disorders of connective tissue structure of genetic origin. The article provides an overview of current medical literature on the causes and diagnosis of PROM. Preliminary own data on the positive effect of the advanced algorithm for detecting undifferentiated connective tissue dysplasia (UCTD) on obstetric and perinatal outcomes are also given.
The objective: to clarify the causes of PROM, the role of the severity of connective tissue dysplasia to predict risk factors for preterm birth, especially when combined in pregnant women with anemia.
Materials and methods. A total of 60 pregnant women with IDF were examined. During the survey, laboratory and instrumental methods were used.
Results. Quality of life in women with NDTT had an inverse mean relationship between the patients’ well-being and the number of PST phenotypic manifestations (r = 0.653; p> 94%). In addition, a high constitutionally determined level of personal anxiety was established. Quality of life depends on the number and severity of phenotypic abnormalities, ie the more signs of connective tissue dysplasia (joint hypermobility, scoliosis, nephroptosis, increased bleeding, myopia, pronounced varicose veins, etc.), the lower this indicator. As pregnancy progressed, worsening of health and decrease in quality of life in patients with NDST was observed.
Conclusion. The advanced algorithm has demonstrated the positive effects in pregnant women with undifferentiated connective tissue dysplasia on obstetric and perinatal delivery, and the findings suggest that it is practiced in health care.
Key words: premature rupture of membranes, preterm pregnancy, undifferentiated connective tissue dysplasia.

REFERENCES

1. Berg CJ, Atrash HK, Koonin LM et al. 2010. Pregnancy-related mortality in the United States, 2010. J. Obstet. Gynecol. 88:161–167. https://doi.org/10.1016/0029-7844(96)00135-4

2. Baskett TF, Sternade J. 2012. Maternal intensive care and near-miss mortality in obstetrics. Brit. J. Obstet. Gynecol. 105:981–984. https://doi.org/10.1111/j.1471-0528.1998.tb10261.x; PMid:9763049

3. Boente M del C, Frontini M del V, Acosta MI et al. 2014. Extensive symmetric truncal aplasia cutis congenital without fetus papyraceous or macroscopic evidence of placental abnormalities. Pediatr Dermatol. 12:228-230. https://doi.org/10.1111/j.1525-1470.1995.tb00164.x; PMid:7501552

4. Golombok S et al. 2013. The European study of assisted reproduction famalies: family functuioning and child development. Human Reproduction. 11:2324-2331. https://doi.org/10.1093/oxfordjournals.humrep.a019098; PMid:8943550

5. Santema Job G, Swaak Astrid M, Wallenburg Henk CS. 2014. Expectant management of twin pregnancy with single fetal death. An International Journal of Obstetric&Gynecology. 102 I;1:26–30. https://doi.org/10.1111/j.1471-0528.1995.tb09021.x; PMid:7833307

6. Crane JM. 2003. Induction of labor with a favourable cervix and/or pre-labour rupture of membranes. best Pract. Res. Clin. Obstetrics Gynecol. 17;5:795–809. https://doi.org/10.1016/S1521-6934(03)00067-1

7. Dare MR, Middleton P, Crowther C et al. 2006. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database Rev. 1. https://doi.org/10.1002/14651858.CD005302.pub2

8. Nosareva SV. 2003. Prezhdevremennoe izlitie okoloplodnyih vod. Metodyi rodovozbuzhdeniya. Diss. kand. med. nauk: 14.00.01. M:141.

9. Voronenko YuV, Shekera OH, Svyrydova NK, Chupryna HM, Dryhant LP, Parniokza TP, Sereda VH, Kustkova HS, Inhula NI, Kravchuk NO, Pavliuk NP, Medvedovska NV. 2014. Aktualni pytannia nervovykh khvorob u praktytsi simeinoho likaria: Posibnyk. K, Lohos.

10. Gunskiy YuI. 2000. Biologicheskaya himiya. K, Ternopol, Ukrmedkniga:507.

11. Evert LS, Borozdun S, Bobrova EI. 2009. Diagnostika displazii soedinitelnoy tkani s ispolzovaniem biomarkerov. Journal of Siberian Federal University. 4:385-390.

12. Belova AN, Shepetova OI. 2002. Shkalyi, testyi i oprosniki meditsinskoy reabilitatsii: rukovodstvo dlya vrachey i nauchnyh rabotnikov. M, Antidor:439.