Maternal morbidity after preterm premature rupture of membranes at <24 weeks’ gestation

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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Predictors of Short Latency Period Exceeding 48 h after Preterm Premature Rupture of Membranes

Journal of Clinical Medicine ◽

10.3390/jcm10010150 ◽

2021 ◽

Vol 10 (1) ◽

pp. 150

Author(s):

Marion Rouzaire ◽

Marion Corvaisier ◽

Virginie Roumeau ◽

Aurélien Mulliez ◽

Feras Sendy ◽

...

Keyword(s):

Maternal Morbidity ◽

Latency Period ◽

Preterm Births ◽

Cervical Length ◽

Short Latency ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Management Method

Background: Preterm premature rupture of membranes (PPROM) is a complication responsible for a third of preterm births. Clinical management is initially hospital based, but homecare management is possible if patients are clinically stable 48 h after PPROM. This study set out to determine factors that are predictive of short latency (delivery ≤ 7 days) exceeding 48 h after PPROM, enabling estimation of the prevalence of maternal and neonatal complications and comparison of maternal and fetal outcomes between inpatient and outpatient management. Method: This was a monocentric retrospective study conducted between 1 January 2010 and 28 February 2017 on all patients experiencing PPROM at 24 to 34 weeks + 6 days and who gave birth after 48 h. Maternal, obstetric, fetal, and neonatal variables were included in the data collected. The primary endpoint was latency, defined as the number of days between rupture of membranes and delivery. Results: 170 consecutive patients were analyzed. Short latency could be predicted by the need for tocolysis, a cervical length less than 25 mm at admission and the existence of anamnios. Outpatient follow-up was not found to lead to increased maternal morbidity or neonatal mortality. Conclusion: Our study highlights predictive factors of short latency exceeding 48 h after PPROM. Knowledge of these factors may provide justification for outpatient monitoring of patients presenting with a long cervix, absence of need for tocolysis and persistence of amniotic fluid and, thus, no risk factors after 48 h of admission.

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Preterm Premature Rupture of Membranes in Twins: Comparison of Rupture in the Presenting Versus Non-presenting Sac

Journal of Obstetrics and Gynaecology Canada ◽

10.1016/j.jogc.2019.06.016 ◽

2020 ◽

Vol 42 (2) ◽

pp. 163-168 ◽

Cited By ~ 1

Author(s):

Elad Mei-Dan ◽

Zoe Hutchison ◽

Mark Osmond ◽

Susan Pakenham ◽

Eugene Ng ◽

...

Keyword(s):

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture

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Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-0903-2735 ◽

2019 ◽

Vol 79 (08) ◽

pp. 813-833 ◽

Cited By ~ 2

Author(s):

Richard Berger ◽

Harald Abele ◽

Franz Bahlmann ◽

Ivonne Bedei ◽

Klaus Doubek ◽

...

Keyword(s):

Preterm Birth ◽

German Society ◽

Consensus Conference ◽

Tertiary Prevention ◽

Short Version ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Gynecology And Obstetrics ◽

Self Help Groups

Abstract Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

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Neonatal lymphocyte subpopulations analysis and maternal preterm premature rupture of membranes: a pilot study

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2021-0375 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Margherita Amadi ◽

Silvia Visentin ◽

Francesca Tosato ◽

Paola Fogar ◽

Giulia Giacomini ◽

...

Keyword(s):

T Cells ◽

Immune System ◽

T Cell ◽

T Helper Cells ◽

Lymphocyte Subpopulations ◽

T Helper ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Helper Cells

Abstract Objectives Preterm premature rupture of membranes (pPROM) causes preterm delivery, and increases maternal T-cell response against the fetus. Fetal inflammatory response prompts maturation of the newborn’s immunocompetent cells, and could be associated with unfavorable neonatal outcome. The aims were to examine the effects of pPROM (Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin N Am 2005;32:411) on the newborn’s and mother’s immune system and (Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A, et al. Factors affecting the latency period in patients with preterm premature rupture of membranes (pPROM). Arch Gynecol Obstet 2011;283:707–10) to assess the predictive value of immune system changes in neonatal morbidity. Methods Mother-newborn pairs (18 mothers and 23 newborns) who experienced pPROM and controls (11 mothers and 14 newborns), were enrolled. Maternal and neonatal whole blood samples underwent flow cytometry to measure lymphocyte subpopulations. Results pPROM-newborns had fewer naïve CD4 T-cells, and more memory CD4 T-cells than control newborns. The effect was the same for increasing pPROM latency times before delivery. Gestational age and birth weight influenced maturation of the newborns’ lymphocyte subpopulations and white blood cells, notably cytotoxic T-cells, regulatory T-cells, T-helper cells (absolute count), and CD4/CD8 ratio. Among morbidities, fewer naïve CD8 T-cells were found in bronchopulmonary dysplasia (BPD) (p=0.0009), and more T-helper cells in early onset sepsis (p=0.04). Conclusions pPROM prompts maturation of the newborn’s T-cell immune system secondary to antigenic stimulation, which correlates with pPROM latency. Maternal immunity to inflammatory conditions is associated with a decrease in non-major histocompatibility complex (MHC)-restricted cytotoxic cells.

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