[Clinical, histopathological and bacteriological evaluation of the sequelae of premature rupture of fetal membranes in parturients after cesarean section]

Abstract

Studies were performed on 83 women, who delivered by cesarean section, as well as on their 84 infants (one bigeminal pregnancy). Five study groups were isolated, namely: I-22 delivering with prematurely ruptured fetal membranes (PRFM) greater than 12 h, II-36 delivering with PFM 12 h. III-58 total of delivering with PRFM, IV--with PRFM + PFM (preserved fetal membranes)--25 delivering (control group), and V - 83 delivering with PRFM + PFM. The evaluation covered clinical data taken from obstetrical history of the delivering woman, course of pregnancy, operation and post-operative period. Histological examinations included the specimens from the uterine muscle, 3 umbilical cord specimens, those of ++extra-placental fetal membrane, as well as placental sections. The inflammatory changes in the studied tissues were classified into: profuse inflammatory infiltrations (+), inflammatory infiltration of minor degree (+/-), and absence of inflammatory infiltration (-). Bacteriological examinations involved smears from vagina and from cervical canal of uterus prior to operation, amniotic fluid taken in the course of operation, as well as pharyngeal smears and gastric content of the newborn infant. It has been shown that in the group of bearing women, in whom the time from PRFM to delivery was longer than 12 hours more harmful consequences were observed than in the group of bearing women, in whom this period was shorter than 12 hours, and that the length of the period itself from PRFM moment to the delivery does not exert any influence on the increase in the rate of infections in the bearing mothers. It has been ascertained that immediate consequence of PRFM for the mother is the rise in the incidence rate of amniotic fluid infection, while the consequence in respect of the newborn infant is an increased incidence rate for children being born with poorer general conditions in cases with preserved fetal membranes at the time of delivery, and also that whenever the period from PRFM to delivery is longer than 12 hours there is great likelihood that inflammatory infiltrations may appear in the uterine muscle of the bearing women, examined frequently "per vaginam" at the time preceding the parturition and during the latter's course.(ABSTRACT TRUNCATED AT 400 WORDS)