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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/288: 399-405 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/288: 399-405

Title: Preterm premature rupture of membranes: prediction of risks in women of Zaporizhzhia region of Ukrain

Authors: Lyubomirskaya K, Krut Y, Sergeyeva L, Khmil S, Lototska O, Petrenko N, Kamyshnyi A. 

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Preterm premature rupture of membranes: prediction of risks in women of Zaporizhzhia region of Ukraine


Lyubomirskaya K1, Krut Y1, Sergeyeva L2, Khmil S3, Lototska O4, Petrenko N5, Kamyshnyi A6.

1Department of Obstetrics and Gynecology, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine; 2Department of the Medical Physics, Biophysics and Higher Mathematics, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine; 3Department of Obstetrics and Gynaecology No 1, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 4Department of Obstetrics and Gynaecology No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine; 5Department of Microbiology, Virology and Immunology, Zaporizhzhia State Medical University, Zaporizhzhia, Ukraine

The etiology of preterm premature rupture of membranes (PPROM), which is responsible for approximately 30% cases of preterm birth (PTB) is not yet fully understood.
The aim of the study
was to create a mathematical model for prognostication of PPROM based on the anamnesis, clinical data, laboratory findings and genetics predictors.
Material and methods
. The study involved 80 women with PPROM (between 26 and 34 weeks of gestation) and 50 women having term birth (>37 weeks of gestation) of Zaporizhzhia region of Ukraine. Anamnesis, clinical, laboratory data and single nucleotide polymorphism sequencing of interleukin 1β (IL1β), tumor necrosis factor α (TNFα), interleukin4 (IL4), interleukin10 (IL10) and Relaxin 2 (RLN2) genes has been analyzed. Receiver operating characteristic analysis and multivariate logistic regression were used to PPROM predictors identification.
Results
. We have identified prognostic anamnestic (history of preterm birth), clinical (cervical insuffiency, compromised uteroplacental and fetal circulation), microbiological (vaginal dysbiosis) and hematological criteria for intra-amniotic contamination and further development of PPROM and PTB: WBC>12.3×109/L, GRAN>76%, LYM2.8. Also we have found that GG genotype of IL10 gene polymorphism (rs1800872) leads to a 12.5-fold and CT genotype of RLN2 gene polymorphism (rs4742076) leads to a 17.0-fold increase in risk for PPROM.
Conclusions
. The prognostic model that we have suggested is an adequate and convenient instrument for practical medical use, which allows for assessment of PPROM probability with a 85% sensitivity and a 72% specificity.

Key words: preterm premature rupture of membranes, risks prediction

Pol Med J, 2020; XLVIII (288); 399–405