Nitochko K. Prediction, prevention and ways to reduce intrauterine infection at preterm pregnancy and premature rupture of membranes

The thesis is a new solution of actual problems of modern perinatology - the management of preterm pregnancy with premature rupture of membranes to reduce the frequency of intrauterine infection and perinatal losses. Based on the comparison of postnatal outcomes of pre-term infants and taking into account the length of the dry period, and also the gestational age, the author show the expediency of the obstetric tactics aimed at prolongation of pregnancy against the background of PROM at terms over 28 weeks for the term of 48 - 168 hours, that assisted the decrease of perinatal morbidity, notably diminished frequency of serious forms of respiratory distress syndrome, without the increase of infectious complications for women. After 32 weeks the protracted prolongation of premature pregnancy (more than 7 days), complicated by PROM, is inadvisable. Based on a prospective study determined that reliable prognostic criteria of intrauterine infection in preterm pregnancy and PROM are the presence of a woman active markers of urogenital infection, oligohydramnios, the increasing of "C" -reactive protein > + +, decrease glucose level in amniotic fluid (less than 1 mmol/l) , the duration of latency period more than 168 hours during gestation to 32 weeks.