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Labor Induction In Women With The Intrauterine Growth Retardation At Preterm


Author: Manceva Maria
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2018
Scientific advisers: Marin Rotaru
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Ion Fuior
doctor habilitat, professor, Public Medical Sanitary Intitution Scientific Research Institute of Mother and Child Health Care
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 20 February, 2018 at the meeting of the Scientific Council and now it is under consideration of the National Council.

Abstract

Adobe PDF document1.78 Mb / in romanian

Thesis

CZU 618.33+618.396:[618-085.357+615.357.6:577.175.859.03]

Adobe PDF document 14.91 Mb / in romanian
148 pages


Keywords

Intrauterine Growth Retardation (IUGR), Mifepristone, labor preinduction, preterm labor

Summary

The thesis includes: introduction, 4 chapters, general conclusions, recommendations, bibliography with 193 references, 123 pages of the basic text, 46 tables, 33 figures and 3 annexes. The results of the research are presented in 10 scientific publications.

Aim of the study:to improve the method of labor preinduction in women with the IUGR in order to preserve fetal and mother health and well-being.

Objectives: Clinical estimation of pregnancy and preterm birth associated with IUGR with the risk factors appreciation; to observe clinical and paraclinical efficacy of Mifepristone and Misoprostol for preinduction cervical ripening; to record fetal assessment during labor preinduction in women with the IUGR at preterm; to compare the efficacy of Mifepristone and Misoprostol for labor preinduction at preterm associated with IUGR; to establish an algorithm of labor preinduction at preterm associated with IUGR.

Novelty and scientific originality: for the first time in the Republic of Moldova, clinical trials, presented in the study, established the efficacy of new method of labor preinduction in women with the IUGR at preterm. It was found that the administration of Mifepristone is an effective method for cervical ripening and labor induction at preterm associated with IUGR. It was carried out a comparative analysis of the results after the administration of mifepristone and misoprostol for labor preinduction in women with the Intrauterine Growth Retardation Syndrome.

The findings suggest that the administration of Mifepristone appears to be more effective and safe method for cervical ripening and labor induction at preterm associated with IUGR than Misoprostol. Mifepristone is not only highly efficient, but it is generally acceptable to women. It does not affect fetal, newborn and mother health.

Scientific problem solved in the respective field: demonstrating the efficacy of Mifepristone for labor preinduction in women at preterm associated with the Intrauterine Growth Retardation Syndrome helped to establish an algorithm of labor preinduction and optimize the use of the method of labor preinduction in women with the IUGR.

The theoretical significance of the study: Clinical estimation of pregnancy and preterm birth associated with IUGR with the risk factors appreciation. Were observed clinical and paraclinical efficacy of Mifepristone and Misoprostol for preinduction cervical ripening. Was recorded fetal assessment during labor preinduction in women with the IUGR at preterm. Was compared the efficacy of Mifepristone and Misoprostol for labor preinduction at preterm associated with IUGR.

Was established an algorithm of labor preinduction at preterm associated with IUGR.

Applicative value of the study: The results of the study are considered to be included in national protocols regarding labor preinduction in women with the Intrauterine Growth Retardation in order to reduce the rate of cesarean deliveries with IUGR at preterm.

Scientific results are implemented in the activity of specialists from the Research Institute for Maternal and Child Health care and provide a methodological support for the comprehensive management of patients with IUGR, and for training in the field of obstetrics.