[Premature rupture of fetal membranes]. / Predcasný odtok plodové vody.

OBJECTIVE: Review of issues of premature rupture of membranes. DESIGN: Review article. SETTING: Institute for the Care of Mother and Child, Prague, Czech Republic, Department of Gynaecology and Obstetrics, Institute for Postgraduate Medical Education, Prague, Czech Republic, Department of Gynaecology and Obstetrics, Charles University Hospital, Pilsen, Czech Republic. METHODS: Critical review of available information on issues of premature rupture of membranes with special attention to recommended procedures. RESULTS: Incidence of premature rupture of membranes varies from 4.5% to 14% and in about 30% of cases it is a cause of preterm delivery, and therefore it contributes substantially to perinatal and infant mortality and morbidity. To minimize this effect, recommended procedures are stipulated. Different types of clinical situations are evaluated and specific measures listed to provide practical guidelines based on available information. CONCLUSIONS: Premature rupture of membranes is an important topic in perinatology and proper management can affect pregnancy outcome. This article provides up-to-date recommended procedures in particular situation during pregnancy with focus on practical measures.

[Artificial interruption of pregnancy in primigravidae as a risk-factor for further pregnancies (author's transl)]. / Umelé prerusení tehotenství primigravid jako rizikový faktor dalsího tehotenství.

PIP: In order to study the effects of abortion on subsequent pregnancy, 13,144 secundigravidae were studied. In 879 of those women the 1st pregnancy had ended in miscarriage, in 820 it ended in abortion, in 25 in tubal pregnancy, in 7 in molar pregnancy, in 294 in premature delivery, and in 11,119 in normal delivery at term. Of the complications of early pregnancy, threatened abortion was the most common. 13.8% of the women who had miscarried previously experienced this complication, as did 9.1% of those who had had an abortion, 9.1% of those who delivered prematurely, and 3.6% of women who experienced normal deliveries. Other complications were equally common in all 4 subgroups. In the 2nd half of pregnancy, miscarriage was about twice as common among women who had had an abortion or miscarriage during their 1st pregnancy as it was in women whose 1st pregnancy was not interrupted. Furthermore, women who had miscarried or aborted the 1st pregnancy were twice as likely as women who delivered at term to give birth to infants weighing less than 2500 gm. Women who had delivered the 1st pregnancy prematurely were about 4 times as likely to have a subsequent premature delivery as were women whose 1st pregnancies ended at term. Thus it appears that interruption of a 1st pregnancy - either by abortion or miscarriage - significantly increases the risk of miscarriage in a subsequent pregnancy.^ieng