Perinatal complications of membrane premature rupture depending on laboratory markers of amniotic fluid
DOI:
https://doi.org/10.15574/HW.2024.5(174).3741Keywords:
premature rupture of membranes, amniotic glucose and creatinine concentration, hyperthermia in labor, chorioamnionitis, fetal distress, meconium staining of the fluidAbstract
Premature rupture of membranes complicates up to 10% of all births, but in the case of premature pregnancy it is the cause of one third of premature births.
Aim - to investigate the influence of low glucose concentration and increased creatinine content in amniotic fluid on the course of labor in case of premature rupture of membranes for improvement of management.
Materials and methods. The course of pregnancy in 200 women with premature rupture of membranes was analyzed. The Group 1 consisted of 50 pregnant with preretm gestation and glucose content >0.5 mmol/l, the Group 2 - 50 pregnant with preterm gestation and glucose content <0.5 mmol/l, the Group 3 - 50 pregnant in term and glucose content >0.5 mmol/l and the Group 4 – 50 pregnant in term and glucose content <0.5 mmol/l. Each group, depending on the creatinine content, was divided into subgroups A and B, the subgroup A included women with creatinine <200 mmol/l, and B - >200 mmol/l. In all pregnant women, the frequency of hyperthermia before the onset of labor and during labor, fetal distress and the need for operative delivery were analyzed.
Results. Patients with low glucose levels in amniotic fluid are more likely than those with normal glucose levels to have hyperthermia before labor begins (40% vs. 6% in preterm pregnancy, 64% vs. 10% in term pregnancy). Also noteworthy is the higher frequency of hyperthermia within 12 hours - 26% vs. 4% in preterm pregnancy, 44% vs. 6% in term pregnancy. An increase in creatinine levels against the background of low glucose levels in amniotic fluid in 35.7% is accompanied by fetal distress during labor (in women with normal creatinine levels - no more than 8.3%).
Conclusions. In women with premature rupture of membranes, reduced amniotic glucose concentration increases the risk of hyperthermia before the onset of labor and during labor, as well as other criteria for chorioamnionitis in both full-term and preterm pregnancies. Pregnant women with amniotic creatinine concentration greater than 200 mmol/l and low glucose levels have a higher rate of complications, such as fetal distress and meconium staining of the fluid.
The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committee of the participating institution. Informed consent was obtained from all patients.
The authors declare no conflict of interest.
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