The role of ascending amniotic infection in the genesis of premature separation of the normally implanted placenta

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Abstract

Objective: To explore the influence of premature separation of the normally implanted placenta in combination with ascending amniotic infection on obstetric outcomes and conditions in newborns.

Materials and methods: The retrospective analysis of medical documentation of 108 patients was performed. Group 1 included 40 puerperant women with premature separation of the normally implanted placenta associated with infectious lesions of the placenta. Group II (the control group) included 60 patients with only premature separation of the normally implanted placenta.

Results: Comparison between the groups I and II showed that the women in group I gave birth at 35 (31;38) weeks versus 37 (35;39) weeks in Group II; 25/40 (62.5%) women gave birth prematurely versus 27/69 (39.1%). Preterm births before 33 weeks of pregnancy occurred in 3/40 (32.5%) versus 10/69 (14.5%.) women. Time interval between membrane rupture and delivery was longer – 12 hours and 30 minutes versus 3 hours and 45 minutes. In 7/17 (41.2%) versus 3/28 (10.7%)women, this time interval was > 24 hours. Preterm babies were born with asphyxia, required respiratory support and antibiotic therapy. Postnatal death occurred exclusively among preterm babies.

Conclusion: Premature separation of the normally implanted placenta of infectious genesis occurs as a result of ascending amniotic infection, often against the background of preexisting impairment of uteroplacental blood flow. Inflammatory conditions of the placenta are one of the causes of premature separation of the normally implanted placenta and are associated with preterm babies with birth asphyxia.

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About the authors

Irina Iu. Breslav

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University)

Author for correspondence.
Email: irina_breslav@mail.ru
ORCID iD: 0000-0002-0245-4968

Dr. Med. Sci., Professor at the Savelyeva Department of Obstetrics and Gynecology of the Institute of Maternity and Childhood

Russian Federation, Moscow

Raisa I. Shalina

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University)

Email: raisa.shalina@gmail.com
ORCID iD: 0000-0001-7121-1663

Dr. Med. Sci., Professor at the Savelyeva Department of Obstetrics and Gynecology of the Institute of Maternity and Childhood

Russian Federation, Moscow

Marina L. Kolotilova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: Kolotilovaml@hotmail.com
ORCID iD: 0000-0001-7270-8671

Dr. Med. Sci., Professor at the Pathological Physiology Department, Institute of Biodesign and Modeling of Living Systems

Russian Federation, Moscow

Olga P. Barykina

Clinical Hospital MD GROUP, JSC “MD PROJECT 2000”

Email: medslovar@mail.ru
ORCID iD: 0000-0003-4943-0741

pathologist, Head of the Department of Pathology

Russian Federation, Moscow

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