PREVENTION OF PREMATURE BIRTHS

Objective. To reduce premature birth rates, by optimizing the management tactics for high-risk pregnant women and by using an elaborated package of therapeutic and diagnostic measures. Subjects and methods. A retrospective group included 112 women who had given birth prematurely and followed up in the maternity clinics of Kaliningrad in 2004 to 2009. A prospective group consisted of 124 women at high risk for premature birth, followed up in early pregnancy at Maternity Home One, Kaliningrad Region. Results. The causes of the 2004—2009 premature births were retrospectively analyzed; their outcomes were assessed. By using the obtained results, the author made up a prospective group of pregnant women at high risk for premature births. A pregnancy management plan was developed, by taking into account diagnostic criteria: the efficiencies of vaginal pH-metry, Actim Partus test systems diagnosing premature births, and an Actim Prom system diagnosing premature amniorrhea were evaluated. The efficiency of different tocolytic therapy options to prevent threatened premature labor was also evaluated with regard for the term of pregnancy and the need to prevent neonatal respiratory distress syndrome. On the strength of the obtained data, the author has elaborated a package of therapeutic and diagnostic measures to prevent premature birth at Maternity Home One, Kaliningrad Region. Conclusion. An intensive follow-up of pregnant women, early diagnosis using the highly specific test systems, timely recovery of vaginal normocenosis, and prevention of fetal distress syndrome in the groups of women at high risk for premature births can optimize pregnancy management tactics and the timely use of a complex of the developed therapeutic measures reduces premature birth rates.

premature birth, vaginal pH-metry, phosphorylated insulin-like growth factor binding protein 1, tocolytic therapy, prevention of fetal respiratory distress syndrome