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PERINATAL RISK IN PRETERM BIRTH: NEW OBSERVER OPPORTUNITIES
Kamilla Farxodovna Rayimjanova
The 1st year Master's degree resident of the
Department of Obstetrics and Gynecology №3
Samarkand State Medical University
N.N. Shavazi
Scientific supervisor: DSc.
https://doi.org/10.5281/zenodo.14647884
Objective:
to consider the impact of preterm birth on obstetric complications, diagnostic
methods and types of correction of various disorders, as well as the results of the study.
Materials and methods of research.
The study was performed in the Regional Perinatal
Center of the city of Samarkand in the department of pathology of pregnant women. A total of
700 pregnant women were examined to assess risk factors for the development of PR. We
retrospectively analyzed 350 birth histories for 2017-2019, prospectively analyzed the initial
clinical characteristics, as well as the features of the course of pregnancy. Pregnant women were
included in the study as they were referred. The inclusion criteria were: pregnant women with a
period of 30-34 weeks, the age of pregnant women 18-36 years, a history of medical abortion (1
or more abortions in history), women who had a history of PR, women who had a history of
premature rupture of amniotic fluid, and exclusion criteria: gestational age less than 30 weeks,
anomalies and tumors of the uterus and ovaries, isthmic-cervical insufficiency, multiple pregnancy,
complicated preeclampsia, decompensated placental insufficiency, congenital malformations of
the fetus, severe somatic pathology.
Under our supervision were 350 pregnant women. The main group consisted of 250
pregnant women with a gestational age of 28-35 weeks of pregnancy, who were divided into 3
groups according to the history. The control group consisted of 100 pregnant women with a
physiological course of pregnancy.
Research results.
In those examined with PR, an increase in the frequency of risk factors
was observed in comparison with women with a preserved pregnancy: stress (31.2%), bad habits
(3.6%), age under 18 after 30 years (6.33%), history of abortion (44.7%), gynecological diseases
(56.5%), threatened miscarriage (99.5%), early preeclampsia (100%), PT up to 22 weeks (0.90%),
PT up to 36 weeks (45.2%), cardiovascular diseases (5.4%), hypertensive disorders (11.3%).
Based on multiple studies and the information content of the biochemical composition of
blood and AF, we carried out a biochemical analysis of all indicators.
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Based on the obtained results, we would like to note that in the blood and in the AF, the
changed parameters were similar. I noticed a change in urea, which was observed in 70% of
women in the period of 28-35 weeks.
Of interest is the assessment of the urea content in the mother-fetus system. In the mother's
blood at the time of the birth of the child, the average urea content does not differ significantly
from that in cord blood and varies within relatively small limits - from 6.39 to 3.0 mmol / l. The
concentration of urea in the amniotic fluid (6.9±0.56 mmol/l) in all cases increases its level in the
cord blood and in the mother's blood.
The next task before us was the question of the method of delivery of a pregnant woman
with preterm labor that had already begun, taking into account complications or the mother's
consent to a caesarean section. When considering perinatal outcomes at 34-36 weeks of gestation,
vaginal births were 1.3 times less likely to have hypoxia at birth, and the incidence of respiratory
distress syndrome was significantly lower. Perinatal outcomes at 31-33 weeks of gestation SDR
was 2.4 times more likely to occur in children born by caesarean section.
Conclusion.
Thus, our study of perinatal outcomes of PR, depending on the tactics of
delivery, showed that premature babies at 34-36 weeks 6 days have a very low incidence of IVH
(0.58%) and it does not depend on the method of delivery. However, the frequency of SDR is
significantly higher (3.7 times) in children born by caesarean section. Thus, we can say that the
optimal method of delivery for premature babies at 34-36 weeks 6 days is vaginal delivery. At 28-
30 weeks, all newborns develop SDR and all children require respiratory support. We did not find
a significant difference between the required ventilation parameters and the method of delivery.
At the same time, the frequency of IVH was 2.5 times higher in children born through the natural
birth canal. When calculating the relative risk, it was found that in the case of vaginal delivery at
28-30 weeks, the risk of IVH is increased by 2.5 times than with a cesarean section, and the
frequency of IVH reaches almost 15%.
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