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ASSESSMENT EFFICACY AND SAFETY INDUCTION OF
LABOR IN PATIENTS WITH PREMATURE RUPTURE OF
MEMBRANES
Mukhtorova S.A., master’s degree 2 nd year, department of obstetrics
and gynecology
Research advisor: DSc, Kamilova I.A., department of obstetrics and
gynecology in Tashkent Medical Academy,
Relevance of the topic.
In modern obstetrics, the rate of premature rupture of the
membranes ranges from 1% to 19.8% all over the world. In the maternity complex of the
Tashkent Medical Academy, the need for induction of labor in this indicator is close to 2%.
Complications of premature rupture of the membranes depend on the duration of fetal waters and
water-free intervals, and may even be complicated by antenatal fetal death. If the interval without
water is 24-72 hours, perinatal fetal death due to infectious diseases is 3.57%, and if it is more
than 72 hours, it is 5.6%. To prevent these complications, prostaglandin E2 drugs have been used
to induce cervical ripening and natural childbirth.
The purpose of the study.
To study the course of labor and its complications in women
diagnosed with prenatal rupture of the membranes after induction of labor.
Research materials and methods
. Through a prospective scientific research, 58
singleton women with a gestational age of 37-41 weeks who applied to the maternity complex of
the multidisciplinary clinic of the Tashkent Medical Academy in March and April 2022 were
included. The main (first) group consisted of 34 pregnant women diagnosed with antepartum
rupture of the membranes, and labor was induced with Glandin E2 (Dinoprostone, 3mg) 2 types
of intracervical tablets, the control (second) group consisted of 24 women with natural
physiological consists of a woman in labor. Examination methods consist of general clinical-
laboratory, special obstetric examination, instrumental and statistical methods. Using the Bishop
scale, the cervix was evaluated as "immature" up to 6 points, 6-8 points as "insufficiently
developed", and "mature" if it was greater than 8 points.
Research results.
Indications for labor induction: rupture of the membranes before labor
was 34 (100%) patients. The average age of women included in the examination is 28 years in
the main group; 25 years in the control group. In the main group, 20 (58.8%) are first-time
mothers, 14 (41.2%) are repeat mothers; in the control group there were 12 (50%) women who
gave birth for the first time, and 12 (50%) women who gave birth again. In the main group, all
patients were assessed as "immature" cervix according to the Bishop scale before labor induction.
As a result of induction of labor in the main group, 28 (82.4%) patients were assessed as "mature"
cervix according to Bishop's scale, 12 (35.3%) patients - I type; 22 (64.7%) patients - due to the
successful induction of type II labor, labor was terminated by natural physiological means. In
this group, 6 (17.6%) patients underwent cesarean delivery due to "immaturity" of the cervix
according to the Bishop scale. Obstetric complications: slowness of regular labor activity in the
main group - 2 (5.9%); in the control group, this indicator showed - 2 (8.%) patients. Birth trauma
in the main group 12 (35.3%); in the control group is 3 (12.5%). In the main group, manual
separation of the placenta was performed in 4 (11.8%) cases in the third stage of labor. The
amount of blood lost during childbirth was 292 ml in the main group; 500 ml in the control group.
Duration of labor in the main group is 6-7 hours; in the control group it was 14-15 hours. The
water-free interval was 33 hours in the main group. Despite antibiotic prophylaxis, 4 (11.8%)
patients developed chorioamnionitis. The condition of the newborn according to the Apgar scale
is 8-9 points in all cases in the main group; in the control group it was evaluated with 7-8 points.
Summary.
The effectiveness of induction of labor was shown by the fact that the rate of
operative deliveries decreased by 6 times in the case of rupture of the membranes before delivery
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by labor induction. The need for induction of labor due to rupture of the membranes before
childbirth is high (58.8% and the average age is 28 years) in women who have given birth for the
first time and are older. The risk of developing choriamnionitis depends on the duration of the
waterless interval.
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