Liubomyrska K. Prevention of premature rupture of membranes in premature pregnancy

The dissertation is devoted to the study of measures aimed at improving the efficiency of forecasting and optimizing the tactics of premature rupture of membranes (PPROM) in premature pregnancy. The results of the study of the state of innate, adaptive immunity in the placenta and amniotic membranes, the association of single-nucleotide polymorphism of pro- and anti-inflammatory cytokine genes, the concentration of fetoplacental complex hormones, the assessment of integrated indicators of endogenous intoxication in 80 women with PPROM in term further initiation of premature birth. During the study, patients were divided into 2 groups: 1 (main) group – 80 women with PPROM in 26-34 weeks of pregnancy and 2 (control) group – 50 women with physiological course of pregnancy and urgent delivery without complications. The mean age of the examined women was 29.60 ± 6.30 years. The mean duration of PPROM in the main group of the study was 31.03 ± 2.48 weeks, the duration of the anhydrous interval was 114 hours (from 9 to 313 hours). According to the results of the analysis of the association of single nucleotide polymorphism (SNP) with the occurrence of PPROM in premature pregnancy by polymerase chain reaction with reverse transcription in real time, genotypes of predisposition to high risk of complications and genotypes have been identified. In the course of the analysis of the results of the examination of patients it was found that the AG genotype of the RLN2 polymorphism (rs3758239) - RR = 0.67 95 % CI 0.05-0.54; CC genotype of RLN2 polymorphism (rs4742076) - RR = 0.59 95 % CI 0.46-0.75; TG genotype of IL10 polymorphism (rs1800872) - RR = 0.49 95 % CI0.32-0.73. In the population of Zaporozhye region, the presence of CT genotype polymorphism RLN2 (rs4742076) increases the risk of PPROM in premature pregnancy by 17 times (95 % SI 2.29-125.67), GG genotype polymorphism IL10 (rs1800872) by 12.5 times (95 % SI 3.07-50.85) and AA genotype of the RLN2 polymorphism (rs3758239) 1.74 times (95% SI 1.33-2.28).