The role of ascending amniotic infection in the genesis of premature separation of the normally implanted placenta
Breslav I.Iu., Shalina R.I., Kolotilova M.L., Barykina O.P.
Objective: To explore the influence of premature separation of the normally implanted placenta in combination with ascending amniotic infection on obstetric outcomes and conditions in newborns.
Materials and methods: The retrospective analysis of medical documentation of 108 patients was performed. Group 1 included 40 puerperant women with premature separation of the normally implanted placenta associated with infectious lesions of the placenta. Group II (the control group) included 60 patients with only premature separation of the normally implanted placenta.
Results: Comparison between the groups I and II showed that the women in group I gave birth at 35 (31;38) weeks versus 37 (35;39) weeks in Group II; 25/40 (62.5%) women gave birth prematurely versus 27/69 (39.1%). Preterm births before 33 weeks of pregnancy occurred in 3/40 (32.5%) versus 10/69 (14.5%.) women. Time interval between membrane rupture and delivery was longer – 12 hours and 30 minutes versus 3 hours and 45 minutes. In 7/17 (41.2%) versus 3/28 (10.7%)women, this time interval was > 24 hours. Preterm babies were born with asphyxia, required respiratory support and antibiotic therapy. Postnatal death occurred exclusively among preterm babies.
Conclusion: Premature separation of the normally implanted placenta of infectious genesis occurs as a result of ascending amniotic infection, often against the background of preexisting impairment of uteroplacental blood flow. Inflammatory conditions of the placenta are one of the causes of premature separation of the normally implanted placenta and are associated with preterm babies with birth asphyxia.
Authors' contributions: Breslav I.Iu., Kolotilova M.L., Barykina O.P. – the concept and design of the study, manuscript writing; Breslav I.Iu. – material collection and processing; Shalina R.I. – manuscript editing.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was approved by the Ethics Committee of the N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia (Pirogov University).
Patient Consent for Publication: The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Breslav I.Iu., Shalina R.I., Kolotilova M.L., Barykina O.P. The role of
ascending amniotic infection in the genesis of premature separation of the normally implanted placenta.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (10): 74-82 (in Russian)
https://dx.doi.org/10.18565/aig.2025.198
Keywords
premature separation of the normally implanted placenta
chorioamnionitis
preterm birth
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Received 18.07.2025
Accepted 18.09.2025
About the Authors
Irina Iu. Breslav, Dr. Med. Sci., Professor at the Savelyeva Department of Obstetrics and Gynecology of the Institute of Maternity and Childhood, Pirogov RussianNational Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1, +7(903)205-62-84, irina_breslav@mail.ru,
https://orcid.org/0000-0002-0245-4968
Raisa I. Shalina, Dr. Med. Sci., Professor at the Savelyeva Department of Obstetrics and Gynecology of the Institute of Maternity and Childhood, Pirogov Russian
National Research Medical University, Ministry of Health of Russia, 117997, Russia, Moscow, Ostrovityanov str., 1, +7(495)718-34-72, raisa.shalina@gmail.com,
https://orcid.org/0000-0001-7121-1663
Marina L. Kolotilova, Dr. Med. Sci., Professor at the Pathological Physiology Department, Institute of Biodesign and Modeling of Living Systems, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, 119991, Russia, Moscow, Trubetskaya str., 8 bld. 2, +7(903)201-75-31, Kolotilovaml@hotmail.com,
https://orcid.org/0000-0001-7270-8671
Olga P. Barykina, pathologist, Head of the Department of Pathology, Hospital MD GROUP, 117209, Russia, Moscow, Sevastopolsky Ave., 24/1, +7(495)332-20-22, medslovar@mail.ru, https://orcid.org/0000-0003-4943-0741
Corresponding author: Irina Iu. Breslav, irina_breslav@mail.ru
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