Naşterea prematură la termene de gestaţie între 22-28 săptămâni, aspecte medico-socio-demografice

Abstract

Introduction: This article presents the results of retrospective research that included 830 preterm births between 22-28 gestation weeks and 853 extremely low birth weight newborns (500-1000 g). The goal of the study: During this particular study were analyzed all the medical and socio-demographic particularities of the pregnant women, determining the incidence of such births, the evidence of particularities in pregnancy and birth evolution, perinatal losses establishment, and survival rate of newborns dependent on the terms of gestation and birth weight. Materials and methods: It was used the information from the Statistic wear book of the National Bureau of Statistics of the Ministry of Health, the clinical and laboratory data obtained from the observation records of mother’s, newborns of Neonatal Department of Intensive Care and Resuscitation, and the data from the observation questionnaire. The materials were processed computerized. Results: The study results established a 0,4% incidence of premature births between 22-28 weeks gestation terms out of a total number of births and 9,2% from the number of premature births. Most pregnant women included in the survey belonged to disadvantaged social groups, with a low level of education (64,9%) and a compromised reproductive potential (21,6%). One of five pregnant women was not on the recorded evidence of a family doctor and the first time that they asked for medical care was in the early process of triggering the birth with premature rupture of the amniotic membranes preterm. Each patient’s obstetric history was compounded with 2,6-3,1 reproductive losses, repeated miscarriages, and premature births. The most encountered causes that induced premature birth at 22-24 weeks of gestation were urinary and vaginal infections, repeated abortions in early pregnancy terms, complications during pregnancy evolution, pregnancy-induced hypertension, preeclampsia, placental pathology, polyhydramnios, multiple pregnancies, premature rupture of the amniotic membranes preterm. Conclusions: The studied perinatal losses among children born with extremely low birth weight 500-1000 g., showed a far lower rate (26,2%) of survival compared with similar indicators in the economically developed countries. Of all children born till 25 weeks of gestation, the survival rate was 10,3%. From 527 newborns alive, 60% died in the early neonatal period. Taking into consideration the results, conclusions and recommendations were formulated, aimed to improving the medical care of pregnant women with eminent abortion, as well as of children born with extremely low birth weight 500-1000 g, 22-28 weeks of gestation terms.

Введение: в этой работе представлены результаты ретроспективного анализа 830 случаев преждевременных родов при сроках беременности 22-28 недель и 853 детей, рожденных с экстремально низкой массой тела (ЭНМТ) (500-1000 г.). Материалы и методы: были изучены медико-социальные и демографические особенности беременных, частота родов, особенности течения беременности и родов, перинатальные потери и степень выживаемости детей в зависимости от срока гестации и массы при рождении. Цель исследования: определить медицинские, социальные и демографические особенности при преждевременных родах в сроках гестации 22-28 недель. Результаты: результаты исследования показали, что большинство беременных женщин – 64,9%, принадлежали низкому социальному классу и уровню образования. Более 37% женщин не состояли официально в браке. Каждая пятая женщина не находилась под наблюдением медицинских работников, несмотря на отягощенный соматический, акушерский и гинекологический анамнезы. У каждой женщины были зарегистрированы по 2,6 репродуктивных потерь. Выводы: полученные результаты показали высокий уровень перинатальных потерь, низкую частоту выживаемости детей с экстремально-низкой массой – 26,2%, из рожденных детей в сроке 22-24 нед. не выжил ни 1 ребенок, а выживаемость рожденных в сроке 25 нед. составила 10,3%.