Prolongation of pregnancy to 14 days and ≥14. in case of premature discharge of amniotic fluid

Shubitidze N. G., Gustovarov T. A., Taboridze I. I.

Prematurity is the main cause of perinatal morbidity and mortality in economically developed countries. In about every third case, the development of labor during premature pregnancy is provoked by premature rupture of the membranes and partial or complete rupture of amniotic fluid [1]. Objective: To determine the factors of prolongation of pregnancy with premature discharge of amniotic fluid. Materials and methods: We studied the clinical and laboratory features in 196 patients with prenatal amniotic fluid outflow from the contingent of the clinics Gagua and Pineo, who carried out a pregnancy extension in 2016-2018 with gestational periods of 22-34 weeks. The selection criteria for prolonging the pregnancy of PIU patients was the absence of clinical and laboratory signs of an ascending infection, as well as signs of hypoxia and intrauterine growth retardation. Obstetric management of pregnant women with PRPO consisted in the maximum prolongation of pregnancy in the absence of contraindications. The following were determined: Socio-biological factors of the mother, Obstetric and gynecological history: complicated course of the previous pregnancy, Extragenital diseases, Complications of pregnancy, Fetal status, Ultrasound parameters, laboratory tests - general analysis of blood and urine, bacterioscopy and smear bacteriology. Results: The gestational age during amniotic fluid effusion ranged from 22 to 34 weeks, an average of 29.1 + 3.0, Among 196 pregnant women with untimely discharge of amniotic fluid, prolongation of pregnancy was successful in 138 cases (70.40%). Average prolongation of 31.2 (0-179) days prolongation of 14 days or more was observed in 120 (61.22%) cases (group I) and prolongation failed or continued for less than 14 days in 76 (38.78%) cases (group II). In the prolongation group <14 days. Compared to ≥14, the age of the mother was significantly higher, respectively 28.84 + 5.73 and 26.92 + 5.91 (p = 0.0249), and the male sex prevailed - respectively 54 (71.05%) and 48 (40.00%), p <0.0001. Amniotic fluid (l) - respectively 1.13 + 0.93 and 2.42 + 1.13 (p <0.0001), Cervical length (mm) - respectively 24.39 + 4.63 and 29.45 + 6.84 (p <0.0001), Cervical dilatation (mm) - respectively 3.45 + 2.58 and 1.95 + 2.68 (p = 0.0001). Conclusions: 1. Prolongation of pregnancy depends on socio-biological factors, obstetric and gynecological history and pregnancy factors. 2. Prolongation is promoted by a high average rate of amniotic fluid and cervical length and a low rate of cervical dilatation.

Keywords:Pregnancy prolongation, premature discharge of amniotic fluid