[Frequency of cesarean section in at-term pregnancies with premature rupture of membranes]

The purpose of the present study was to evaluate cesarean section frequency in patients with premature rupture of membranes (PROM) at term, after active management, independent Bishop score. One hundred and four patients was to evaluate, and they was classified in four groups: group 1. nulliparous patients with favorable cervix, group 2. nulliparous patients with unfavorable cervix, group 3. previous delivery patients with unfavorable cervix, group 4. previous delivery patients with favorable cervix. Cesarean section percentage was: 15% in group 1, 24% in group 2, 17% in group 3, and 0% in group 4. Attempt should make to diminish cesarean section frequency, maybe with an expectant management in those patients with PROM at ther and unfavorable cervix.

[Etiologic classification of premature labor and its importance for prevention]

A retrospective analysis of 202 premature deliveries before 37 weeks was performed to identify major pathologies related to preterm delivery. The most frequent pathologies were premature rupture of membranes (32.4%), premature labour without recognisable aetiology (19.1%), hypertensive diseases in pregnancy (15.6%), multiple pregnancies (14.4%), malformations (9.8%) and bleeding in the 3rd trimester (6.4%). The majority of premature deliveries are related to 4 major pathogenetic disturbances: infection, problems of placentation, pathology of the foetus, pathology of the uterus. Each of these pathologies can lead to premature delivery via premature labour, premature rupture of membranes or termination of pregnancy for foetal or maternal pathology. In one third of premature labour, in another preterm premature rupture of membranes with labour after a variable latent period led to delivery, and in the remaining third, delivery was performed by a primary caesarean section or induction of labour for foetal or maternal pathology. Less than 25% cases were considered as failures of tocolytic treatment. Tocolytics, steroids or antibiotics, may help to improve the survival-rate in particular with very low birth-weight infants at less than 30 weeks gestation. A decrease in the overall rate of prematurity can be achieved only by a general improvement of the socio-economic working and living conditions of the female population, in particular of pregnant women.