gynecology and obstetrics medical project, gynecology journal, obstetrics, gynecologic oncology, reproductive medicine, gynecological endoscopy, ultrasonography, gynecology articles

Ginekologia i Poloznictwo
ISSN 1896-3315 e-ISSN 1898-0759

The influence of changes in the premature births prevention and management on the perinatal outcomes in premature infants in a period of 25 years


Abstract

Author(s): Dymitr Żukowski (BE), Krzysztof Preis (AD), Ekaterina Yatskevich (C), Bogumiła Kiełbratowska (F)

Introduction. The incidence of preterm births remains at a constant level of about 6-7%. Preterm births occur as a result of spontaneous premature development of the regular patrimonial activity, preterm premature rupture of the membranes or elective delivery, caused by abnormalities that can complicate pregnancy. The aim of the work was to analyze the influence of various changes in the premature births prevention and management on the state of newborns and their survival during the last 25 years of observations. Materials and methods. There were performed retrospective review and comparative analysis of 80 premature infants histories that were born in the period from 01.01.2009 to 31.12.2013 and consisted the study group. The same number of premature newborns histories that were born in the period from 01.01.1993 to 31.12.1997 were included in the control group. Results. The prolongation of pregnancy as a result of tocolysis did not lead to the reduction of perinatal mortality and the duration of resuscitation. In turn, the use of antenatal corticosteroids reduced the incidence of perinatal infections, as well as the perinatal mortality in the study There was significant decrease of the perinatal mortality in both study groups when using the antibiotic therapy. The significant positive influence of the operative delivery method on the perinatal mortality have not been proved. Conclusions. There was observed the increased proportion of operative premature births without reduction of perinatal mortality and the incidence of congenital infection among premature infants. Prophylactic use of the antenatal corticosteroids reduced the incidence of perinatal morbidity and mortality. We found out the increased frequency of tocolytic agents use while its effectiveness was reduced. Currently, the prolongation of pregnancy does not increase the incidence of congenital infections. It was revealed a significant reduction of the perinatal mortality in premature infants of both study groups if antibiotic therapy was applied.