469: Quantitative fetal fibronectin screening at 24 weeks delineates the risk of spontaneous preterm delivery in asymptomatic patients with a prior history of preterm premature rupture of membranes (PPROM)

2009 ◽  
Vol 201 (6) ◽  
pp. S177 ◽  
Author(s):  
James Kurtzman ◽  
Manju Chandiramani ◽  
Annette Briley ◽  
Lucilla Poston ◽  
Anita Das ◽  
...  
Author(s):  
Zachary Colvin ◽  
Anna Palatnik

This article reviews the study “Fetal Fibronectin in Cervical and Vaginal Secretions as a Predictor of Preterm Delivery,” published in The New England Journal of Medicine in 1991 by Lockwood et al. The study examined the use of fetal fibronectin found in cervicovaginal secretions as a marker for preterm delivery in symptomatic women presenting with preterm contractions or with preterm premature rupture of membranes. The chapter reviews the findings of this study as well as the place of fetal fibronectin testing in current obstetrical practice based on subsequent studies.


2018 ◽  
Vol 11 (1) ◽  
pp. e224596
Author(s):  
Spyros Bakalis ◽  
Anna L David

A spontaneous intra-amniotic haematoma is a rare cause of preterm premature rupture of the membranes (PPROM) but can have significant fetal and maternal consequences. It has previously been reported to occur in the second and third trimesters but not in an earlier gestation. We present a case that presented acutely in the first trimester of pregnancy, which leads to early PPROM at 15 weeks and spontaneous preterm delivery at 28 weeks of gestation. There were no maternal complications during the pregnancy.


2018 ◽  
Vol 36 (01) ◽  
pp. 086-089
Author(s):  
William Grobman ◽  
Annie Dude

Objective The objective of this study was to examine whether a medically indicated preterm delivery is relatively more likely following longer interdelivery intervals. Study Design This is a case–control study of women with two consecutive deliveries of a live singleton at the same institution between 2005 and 2015, with the subsequent delivery occurring preterm. Preterm deliveries were classified as spontaneous if women delivered following preterm labor, preterm premature rupture of membranes, or placental abruption. Preterm deliveries were classified as medically indicated if women underwent delivery for fetal or maternal medical indications. Interdelivery interval was categorized as < 18, 18 to 59, and 60 months or more. Characteristics of women who had a medically indicated versus spontaneous preterm delivery were compared. Results Of the 1,276 women, 25.6% had a medically indicated preterm delivery and 74.4% had a spontaneous preterm delivery. Compared with women with an interdelivery interval of 18 to 59 months (of whom 25.7% had a preterm delivery for medical indications), women with a shorter interdelivery interval were less likely (19.3%), while women with a longer interdelivery interval were more likely (37.4%; p = 0.003) to have a medically indicated preterm delivery. This relationship persisted even when accounting for other factors. Conclusion Preterm deliveries are more likely to be medically indicated as the interdelivery interval lengthens.


2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.


2012 ◽  
Vol 40 (2) ◽  
Author(s):  
Kyo Hoon Park ◽  
Sung Youn Lee ◽  
Shi Nae Kim ◽  
Eun Ha Jeong ◽  
Kyung Joon Oh ◽  
...  

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