Does residual amniotic fluid after preterm premature rupture of membranes have an effect on perinatal outcomes? 12 years experience of a tertiary care center

Objective Amniotic fluid plays a vital protective role in fetal growth and development. Low amniotic fluid index (AFI) during pregnancy increases risk of adverse perinatal outcomes. Prior studies reported association of oligohydramnios (AFI<5 cm) with shorter latency period and inconsistent correlation with chorioamnionitis after preterm premature rupture of membranes (PPROM). We studied effects of oligohydramnios on perinatal outcomes after PPROM. Methods A retrospective cross-sectional study was performed at our medical center on women with PPROM between 23 to 34 weeks during 2014 to 2016. The primary predictor variable was AFI of <5 cm or ≥5 cm in relationship to perinatal outcomes. Results From a total of 117 PPROM cases reviewed, 46 women had AFI<5 cm and 71 had AFI≥5 cm. Length of stay (LOS) in neonatal intensive care unit (NICU) was 42 days for AFI<5 cm versus 26.5 days for AFI>5 cm (p<0.007). The mean neonatal Apgar scores at 1 and 5 minutes (5.2 and 7.4 respectively) were lower in the AFI<5 cm group compared to AFI≥5 cm (6.9 at 1 minute and 8.4 at 5 minutes, p<0.001). Conclusion Oligohydramnios after PPROM is associated with adverse perinatal outcomes such as lower Apgar scores and longer LOS in the NICU. No association was observed with latency period and chorioamnionitis.

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Preterm premature rupture of membranes: maternal and perinatal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184496 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4499

Author(s):

Shweta Avinash Khade ◽

Amarjeet Kaur Bava

Keyword(s):

Maternal Morbidity ◽

Care Center ◽

Tertiary Care ◽

Maternal Outcome ◽

Morbidity And Mortality ◽

Perinatal Morbidity ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Singleton Pregnancy ◽

Preterm Premature Rupture

Background: This is an observational analytical study carried out in department of obstetrics and Gynecology, in a tertiary care center to determine the factors influencing fetal and maternal outcome, prognosis and complications in preterm premature rupture of membrane cases.Methods: The present study is a prospective observational study of perinatal and maternal outcome in 100 cases of preterm premature rupture of membranes in between 2837 weeks gestation with singleton pregnancy, from 1st March 2013 to 28th February 2014. Patients with medical complications like anemia, preexisting hypertension, diabetes, vascular or renal disease, multiple gestations, uterine or fetal anomalies etc. are excluded from the study. Detailed history, physical examinations were carried out and appropriate management instituted as per individual patients need.Results: In this study maternal morbidity was 16%. Perinatal morbidity was 33% and most common causes were hyperbilirubinemia (23%), RDS (21%). Perinatal mortality was seen in 15% and mainly due to RDS (53%). Twenty-five (25%) neonates were delivered by cesarean. The main indications for cesarean being malpresentation (36%) followed by fetal distress (24%).Conclusions: PPROM is one of the important causes of preterm birth that can result in high perinatal morbidity and mortality along with maternal morbidity. Looking after a premature infant puts immense burden on the family, economy and health care resources of the country. An understanding of gestational age dependent neonatal morbidity and mortality is important in determining the potential benefits of conservative management of preterm PROM at any gestation.

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Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.03.269 ◽

2016 ◽

Vol 62 (3) ◽

pp. 269-275 ◽

Cited By ~ 9

Author(s):

Alex Sandro Rolland Souza ◽

Adriane Farias Patriota ◽

Gláucia Virgínia de Queiroz Lins Guerra ◽

Brena Carvalho Pinto de Melo

Keyword(s):

Amniotic Fluid ◽

Pregnant Women ◽

Gestational Age ◽

Perinatal Outcomes ◽

Perinatal Complications ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Amniotic Fluid Index ◽

Apgar Scores ◽

Preterm Premature Rupture

SUMMARY Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

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A prospective study on feto-maternal outcome in patients with premature rupture of membranes at tertiary care center

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20210727 ◽

2021 ◽

Vol 10 (3) ◽

pp. 1022

Author(s):

Patil S. A. ◽

Gaikwad B. H. ◽

Purohit P. ◽

Chintan Upadhyay

Keyword(s):

Prospective Study ◽

Care Center ◽

Tertiary Care ◽

Birth Asphyxia ◽

Perinatal Outcomes ◽

Febrile Illness ◽

Maternal Outcome ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Increased Risk

Background: PROM is associated with increased risk of chorioamnionitis, unfavorable cervix and dysfunctional labour, increased cesarean rates, postpartum hemorrhage and endometritis in the mother. Possible neonatal outcomes in cases of PROM may include respiratory distress syndrome, hypothermia, hypoglycemia, intraventricular hemorrhage, broncho pulmonary dysplasia etc. Objective of this study the maternal and perinatal outcomes in premature rupture of membranes at term.Methods: This prospective study was done among 100 pregnant women with premature rupture of membranes after 37 completed weeks visited at department of obstetrics & Gynecology in RCSM Hospital, Kolhapur during June 2014 and June 2015. Inclusion Criteria was Gestational age of >37 weeks confirmed by dates, clinical examination or ultrasound, cervical dilatation of <3 cms, Lack of uterine contractions for atleast 1 hour from PROM, Single live pregnancy in vertex presentation and PROM confirmed by Direct visualization or Litmus.Results: Present study found highest number of cases among age group 20-24 years and mean age was 22 years. Almost 70% cases were un-booked. Average duration to PROM to hospital admission was 9.6 hours. Most common maternal outcome was febrile illness Most common perinatal outcome was birth asphyxia and 3 perinatal death.Conclusions: Pregnancies complicated with PROM should have supervised labor preferably in an institution. Management of each case has to be individualised. A combined effort of obstetrician and neonatalogist is necessary. A good neonatal intensive care unit can be instrumental in reducing the perinatal morbidity and mortality.

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