Supervisors info:
Νικόλαος Παπαντωνίου, Καθηγητής, Ιατρική, ΕΚΠΑ
Κασσάνος Δημήτριος, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Εμμανουήλ Σαλαμαλέκης, Ομότιμος Καθηγητής, Ιατρική, ΕΚΠΑ
Summary:
Introduction: The general part of the thesis starts with a brief description of the anatomy of the female reproductive system and the physiological changes that occur during pregnancy. Then, the two confusing terms “preterm” and “prematurity” were explained and distinguished from each other. The main causes of preterm birth were also mentioned and categorized, whereas “preterm premature rupture of membranes” was thoroughly developed, as a main cause of pretem birth and a critical complication, the effective management of which is critical for the favorable outcome of pregnancy.
Materials and Methods: The bibliographic material drawn from English and Greek scientific books. Scientific articles were also found by using keywords from the websites Pub Med, the Up-to-date, the best-practise.bmj, sciencedirect and the Cochrane Library’s website.
Results: The special part of the thesis includes a detailed report on the prevalent, based on the current bibliography, predicting factors of “preterm rupture of the fetal membranes” . Every factor was analyzed independently and the correlation with the specific obstetrical complication was based exclusively on medical studies, which were published in internationally recognized medical journals. Firstly, up-to date strategies for the prediction of preterm rupture of membranes were mentioned, which include genetic pathways and specific polymorphisms of genes. The predicting factors were distinguished further to these, that refer to preterm and extreme preterm pregnancies. Furthermore, the factors, that affect the “latency interval” and the rate of recurrence of PPROM were separately reported. Lastly, ay the section of “Special Issues” a special statement on the correlation of PPROM with twin pregnancy and amniocentesis was included, due to the high incidence of these specific predisposing factors.
Conclusion: The most frequent predicting factors of PROM are the African-american race of the mother, smoking, the deficiency of specific nutritional factors, such as zinc and copper. Nulliparity, obstetrical history of pretem birth, vaginal blood discharge at the 2nd and 3rd trimester of pregnancy, endometrial infections, short cervical length (<25mm), multifetal pregnancies and comorbidities of the mother are additional factors, that have impact on the incidence of PROM and can be used by experts for the prevention and therapeutic management of this serious obstetrical complication.
