[The obstetrical management of pregnant patients with spontaneous rupture of the fetal membranes after 37 weeks' gestation].
The purpose of the study was to analyze the obstetric management in pregnancies with spontaneous rupture of membranes (RM) after 37 w.g. and to find out is there a correlation between the cervical status and the pregnancy outcome. The study includes 66 primiparous women divided into two groups depending on the cervical status(CS) at admission: Group 1-44 patients with unfavourable cervix (PS < 4) according to the Bishop's original scoring system and Group 2-22 patients with favourable cervix (PS > 4). The delivery started spontaneously within the first 8 hours after the RM in 59% of the pregnant women with favourable cervix compared to 50% of women with PS < 4. There is no significant difference in the mean duration of the latent period between group 1 and 2-6.3 and 6.2 hours, respectively. The mean duration of delivery was 14.08 hours in Group 1 compared to 14.03 hours in Group 2. 72.7% of the pregnant women in Group 1 had normal vaginal delivery compared to 86.44% of the patients in Group 2. There were 3 newborn (one in Group 1 and 2 in Group 2) with signs of infection. There were no perinatal deaths. Postpartal endometritis was diagnosed in 2 of the patients with unfavourable cervix. There is no motivation to fear the development of ascendant infection in pregnancies with RM after 37 w.g. even if the time elapsed from the very beginning of the RM to the start of delivery is more than 24 hours. We favour both active and passive management of delivery in pregnancies with favourable cervix at the time of RM. We have to reevaluate the active approach in pregnancies with unfavourable cervix and ruptured membranes because of the higher incidence of operative deliveries because of non-progress of labour in these cases.
Mazneĭkova
V
V
Dimitrova
V
V
Tsankova
M
M
Borisov
I
I
D000328:Adult; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D007751:Labor, Induced; D007743:Labor, Obstetric; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D013997:Time Factors