The course and outcome of a pregnancy with a prematura preterm rupture of membranes dilema or liability

• Main Authors: Jovanovic M., Dukanac-Stamenković J.
• Format: Article
• Language: English
• Published: Medicinski fakultet Priština, Društvo lekara Kosova i Metohije Srpskog lekarskog društva 2014-01-01
• Series: Praxis Medica
• Subjects: oligohydramnios; respiratory distress; therapy; outcome
• Online Access: http://scindeks-clanci.ceon.rs/data/pdf/0350-8773/2014/0350-87731401053J.pdf

Preterm premature rupture of membranes (PPROM) is in obstetrics with incidence of 0,4% of , with risk for chorioamnionitis 35%, risk for premature deli very 19%, and sepsis risk of 1%. Primary risk for fetus is pulmonal hypoplasia due to oligohydramnios in 29%, RDS in 66 % of such pregnancies, sepsis in 19%, and contracture of extremities in 3%. Fetal death is more than 30% of cases. Patient came to regular pregnancy check up in 22th week of gestation. US examination revealed decreased fluid volume AFI 50, with regular morphology and fetal dynamic. She was admitted to hospital. She was given cortico-steroids and antibiotics. In further course of pregnancy amniocentesis was performed in 32th week of pregnancy to rule out the infection and to check pulmonal maturity. In absence of infection and lung maturity pregnancy was continued until 36th week of gestation when Cesarean Section was. Baby went well and is now healthy child in the age of three. Some studies suggested that delivery can be significantly prolonged. In our case we managed to gain 14 weeks, from 22th to 36th gestational week. Firstly gynaecologyst nightmare to ask the woman is she accept therapy. The aim is to deliver a healthy child without neurological and other consequences and mother with preserved reproductive function. Controversy still exists when is the appropriate time to finish pregnancy with prolonged PPROM.