HEALTH OF WOMAN. 2019.2(138): 8–13; doi 10.15574/HW.2019.138.8

Benyuk V. O. , Korniets N. G. , Oleshko V. F.
Bogomolets National Medical University, Kiev
SI «Lugansk State Medical University», Rubizhne city

The article highlights the current approaches to the etiology and pathogenesis of miscarriage and preterm birth on the background of premature rupture of membranes. Nowadays, this pregnancy complication becomes relevant not only in the medical aspect. Its high frequency leads to economic, ethical and moral problems, the importance of which depends primarily on the period of pregnancy where it occurred.

The reasons of premature rupture of the membranes are diverse and numerous. One of the hypotheses of this complication development is based on the insufficiency of the membranes’ connective tissue elements, which determine their ability and strength. From this point of view, the role of undifferentiated connective tissue dysplasia and the lack of trace elements that affect the state of the membranes are unconditional.

A number of modern researchers believe the infection is the main cause of progressive disorganization of the amnion components, which is realized through the activation of specific Toll-receptors.

Some studies indicate the role of vaginal biocenosis in the genesis of premature rupture of membranes and consider it as a manifestation of bacterial and viral infections, that persist during pregnancy. In this case, the systemic inflammatory response in pregnant women with premature rupture of the membranes is usually realized through the activation of IL-1, IL-6, IL-8 and TNF, which are early predictors of inflammatory complications.

At the same time, the existing ideas about the polietiopathogenesis of premature rupture of membranes do not reveal all the underlying mechanisms of this pathology, and there are still no modern reliable methods for its prediction and prevention, which contributes to the increase in the frequency of obstetric and perinatal complications in premature pregnancy, significantly worsens the condition of the premature delivered fetus and newborn.

Key words: pregnancy, premature rupture of membranes, infection, undifferentiated connective tissue dysplasia, endothelial dysfunction, cytokine profile.

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