Úvod: Robsonova klasifikácia rodičiek nemá samostatnú kategóriu pre predčasný odtok plodovej vody (PROM) v termíne pôrodu. V našej štúdií sme chceli overiť, nakoľko sa odlišujú rodičky s PROM od rodičiek so spontánnym nástupom činnosti a od skupiny indukovaných rodičiek. Materiál a metodika: Do štúdie sme zahrnuli rodičky, ktoré porodili na našej klinike v období od 1.1.2018 do 30.9.2019. Na základe dokumentácie sme vybrali skupinu rodičiek v termíne, jeden plod hlavičkou a rozdelili sme ich na skupiny podľa dôvodu prijatia – spontánny nástup kontrakcií, spontánny odtok plodovej vody ale-bo indukcia pôrodu. Zvlášť sme hodnotili prvorodičky a viacrodičky bez anamnézy cisárskeho rezu. Výsledky: Frekvencia cisárskych rezov v skupine prvorodičiek prijatých s PROM bola 14,7 %, v skupine prija-tých s rozvinutou činnosťou bola 8,0 % (OR: 0,51; 95% CI: 0,37 – 0,70; p < 0,0001), v skupine žien s indukciou pôrodu bola 20,7 % (OR: 1,51; 95% CI: 1,08 – 2,12; p = 0,0156). Cisárske rezy z indikácie nepokračujúci pôrod tvorili v skupine žien s PROM 10,6 % pôrodov, v skupine s rozvinutou činnosťou 5,4 % pôrodov (OR: 0,48; 95% CI: 0,33 – 0,71; p = 0,0002), v skupine s indukciou pôrodu 13,3 %, rozdiel nebol štatisticky významný. Z indiká-cie hypoxia nebol rozdiel významný medzi PROM a spontánnym začiatkom pôrodu (3,6 % vs 2,3 %), ale oproti indukcii pôrodu (7,1 %) bol rozdiel významný (OR: 2,03; 95% CI: 1,11 – 3,70; p = 0,0217). Podobné výsledky sme zaznamenali aj v skupine viacrodičiek.Záver: Skupina rodičiek s predčasným odtokom plodovej vody vykazuje rozdielne výsledky ukončenia pôro-du aj u prvorodičiek aj u viacrodičiek a zaslúžila by si samostatnú skupinu v Robsonovej klasifikácií.

Introduction: The premature rupture of membranes (PROM) in term pregnancy is not categorized separate-ly in the Robson Classification. The aim of this study is to identify differences between parturiens who were admitted to the labor unit with PROM, spontaneous onset of labor (contractions) and induced labor. Materials and methods: All parturients who delivered at our department were included. The data were obtained from medical records of patients from 1.1.2018 to 30.9.2019. The population of parturiens in term with one fetus in cephalic position was then selected and subdivided according to the cause of admission: spontaneous onset of labor (contractions), spontaneous rupture of membranes and induction of labor. Primi-paras and multiparas without a history of cesarean section where evaluated separately.Results: The frequency of cesarean section in the population of primiparas admitted to the labor unit with PROM was 14.7%, in those admitted with contractions was 8.0% (OR: 0.51, 95% CI: 0.37 – 0.70, p < 0.0001). In the population of parturiens with induced labor, the frequency of cesarean section was 20.7% (OR: 1.51, 95% CI: 1.08 – 2.12, p = 0.0156). Cesarean sections performed out of the indication “prolonged labor” represented 10.6% of all deliveries in the population of parturiens admitted with PROM, 5.4% in the population admitted with contractions (OR: 0.48, 95% CI: 0.33 – 0.71, p = 0.0002). In the population with induced labor those ce-sarean sections represented 5.4% of all deliveries, the difference was not statistically significant. In cesarean sections performed out of the indication “fetal hypoxia”, no significant difference was observed between populations with PROM and spontaneous onset of labor (3.6% vs 2.3%). Comparing to the population with induced labor (7.1%), the difference was statistically significant (OR: 2.03, 95% CI: 1.11 – 3.70, p = 0.0217). Similar results were obtained in the population of multiparas.Conclusion: Different outcomes were recorded in the population of primiparas and multiparas with PROM. A separate category in the Robson Classification for those parturiens would be beneficial.

1 Gynekologicko pôrodnícka klinika LFUK a UNB Nemocnica Ružinov Bratislava Slovenská republika

2 Gynekologicko pôrodnícka klinika LFUK a UNB Nemocnica Ružinov Bratislava Slovenská republika

Prelabor rupture of membranes in term and its position in Robson's cesarean section classification

Literatura