Can neonatal sepsis be predicted in late preterm premature rupture of membranes? Development of a prediction model

Abstract The aim of this study is to evaluate maternal and neonatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes (PPROM) during the late preterm period at 34+ 0–36+ 6 weeks of pregnancy. We conducted a retrospective study on singleton pregnancies with PPROM during the late preterm period using medical records at twelve tertiary medical centres in Korea from January 2007 to December 2016. Data on demographic characteristics and outcome measures were collected. The primary outcomes were maternal sepsis for maternal outcome and neonatal sepsis and neonatal death for neonatal outcomes. Of the 1,072 women, 782 cases (72.9%) were assigned to the immediate delivery group, and 290 cases (27.1%) were categorized into the expectant management group. There was a significant difference in the rate of clinical neonatal sepsis (immediate delivery, 3.8% vs expectant management, 15.8%; p < 0.0001), however, no differences in maternal sepsis (p = 0.5424), culture-proven neonatal sepsis (p = 0.2108), or neonatal death (p = 0.3899) were observed. In conclusion, expectant management in women with PPROM during the late preterm period does not increase the risk of severe maternal and neonatal morbidities and mortality; however, careful monitoring for chorioamnionitis or fetal compromise should be considered during expectant management.

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Acute Histologic Chorioamnionitis Is a Risk Factor for Adverse Neonatal Outcome in Late Preterm Birth after Preterm Premature Rupture of Membranes

PLoS ONE ◽

10.1371/journal.pone.0079941 ◽

2013 ◽

Vol 8 (12) ◽

pp. e79941 ◽

Cited By ~ 23

Author(s):

Seung Mi Lee ◽

Jeong Woo Park ◽

Byoung Jae Kim ◽

Chan-Wook Park ◽

Joong Shin Park ◽

...

Keyword(s):

Risk Factor ◽

Preterm Birth ◽

Neonatal Outcome ◽

Late Preterm ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Adverse Neonatal Outcome ◽

Preterm Premature Rupture ◽

Late Preterm Birth ◽

Histologic Chorioamnionitis

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Effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184130 ◽

2018 ◽

Vol 7 (10) ◽

pp. 4068

Author(s):

Ashima Arora ◽

Ratna Biswas ◽

Bhawna Dubey ◽

Binita Goswami ◽

Sonal Saxena

Keyword(s):

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Inflammatory Marker ◽

Perinatal Outcomes ◽

Admission Rate ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Adverse Perinatal Outcomes ◽

High Level

Background: The aim is to study the effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes (PPROM).Methods: 60 women with PPROM at 28–34 weeks of gestation were enrolled in the study. All the women were given antibiotics as per hospital protocol and were subjected to blood sampling for Interleukin -6(IL-6) at admission, delivery and umbilical cord blood. IL-6 levels were assessed for associations with adverse perinatal outcomes and the effect of antibiotic treatment on IL-6 and perinatal outcomes were studied. The data were analyzed using t test and χ2 test.Results: Increased level of IL-6 was associated with chorioamnionitis and neonatal sepsis (p<0.001). High level of IL-6 led to early delivery and complete course of antibiotics suppressed IL-6 (p<0.001) and clinical chorioamnionitis in women with PROM. Full course of antibiotics also decreased the admission rate of babies to neonatal intensive care unit and suppressed respiratory distress syndrome, neonatal sepsis.Conclusions: Increased level of IL-6 is seen in women with chorioamnionitis and neonatal sepsis. Antibiotics suppress the IL-6 levels, chorioamnionitis and neonatal sepsis.

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Preterm Premature Rupture of Membranes: Clinical Outcomes of Late-Preterm Infants

Clinical Pediatrics ◽

10.1177/0009922809342460 ◽

2009 ◽

Vol 49 (1) ◽

pp. 60-65 ◽

Cited By ~ 13

Author(s):

Julio Mateus ◽

Karin Fox ◽

Sangeeta Jain ◽

Sunil Jain ◽

Richard Latta ◽

...

Keyword(s):

Clinical Outcomes ◽

Preterm Infants ◽

Late Preterm ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Late Preterm Infants ◽

Preterm Premature Rupture

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Management of Late-Preterm Premature Rupture of Membranes

Obstetrical & Gynecological Survey ◽

10.1097/01.ogx.0000427616.81403.bc ◽

2013 ◽

Vol 68 (2) ◽

pp. 89-91 ◽

Cited By ~ 1

Author(s):

David P. van der Ham ◽

Jantien L. van der Heyden ◽

Brent C. Opmeer ◽

Antonius L. M. Mulder ◽

Rob M. J. Moonen ◽

...

Keyword(s):

Late Preterm ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture

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HIGH VAGINAL SWAB STUDY IN PRETERM LABOUR AND PRETERM PREMATURE RUPTURE OF MEMBRANES AND ITS RELATIONSHIP WITH NEONATAL SEPSIS

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/466 ◽

2018 ◽

Vol 5 (30) ◽

pp. 2249-2254

Author(s):

Amina Beevi P ◽

Girija Kumari A.G ◽

Sudhamani C

Keyword(s):

Neonatal Sepsis ◽

Preterm Labour ◽

Vaginal Swab ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture

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A study of perinatal outcome in preterm premature rupture of membranes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184967 ◽

2018 ◽

Vol 7 (12) ◽

pp. 5061

Author(s):

Poovathi M. ◽

Yogalaksmi Yogalaksmi

Keyword(s):

Preterm Birth ◽

Perinatal Outcome ◽

Health Centre ◽

Late Preterm ◽

Morbidity And Mortality ◽

Fetal Membrane ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Preterm Group

Background: Preterm premature rupture of membranes is defined as rupture of fetal membrane before onset of labour at less than 37 completed weeks of gestation and after 28 weeks of gestation. Incidence ranges from 3-10% of all deliveries. Preterm premature rupture of membrane is one of the important causes of preterm birth can result inhigh perinatal morbidity and mortality. Preterm premature rupture of membranes complicates 3% of pregnancies and leads to one third of preterm birth. Preterm delivery affects one in 10 birth in USA and even greater birth in developing continues and causes 40-75% neonatal death. There are numerous risk factors for preterm premature rupture of membrane such as maternal, socioeconomic class, infection at early gestational age and associated co-morbid condition. Both mother and fetus are at greater risk of infection after preterm premature rupture of membrane.The fetal and neonatal morbidity and mortality risks are significantly affected by severity of oligohydrominos, duration of latency and gestation at preterm premature rupture of membrane. The objective is to study perinatal outcome in preterm premature rupture of membrane.Methods: This is a prospective study conducted in Mahathma Gandhi Memorial Government Hospital attached to K. A. P. V. Government Medical College, Trichy, Tamil Nadu, India. This is a tertiary health centre. This study has been conducted from January 2018 to June 2018.Results: Incidence of PPROM ranges from 3.0-10.0% of all deliveries. PPROM complicates approximately 3% of pregnancies and leads to one third of preterm birth.Conclusions: In present study most of newborn had better 5min Apgar especially late preterm group. In present study RDS was common in early preterm group and hyper bilirubinaemia common in late preterm group. In current study most of patients delivered vaginally compared to 36% of LSCS.

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Low Vitamin D Levels Increase the Risk of Early Onset Neonatal Sepsis

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v8i2.1129 ◽

2020 ◽

pp. 87-91

Author(s):

Lisnawati Yuyun ◽

Ali Sungkar ◽

Rinawati Rohsiswatno ◽

Noroyono Wibowo ◽

Denni Hermartin ◽

...

Keyword(s):

Vitamin D ◽

Umbilical Cord ◽

Neonatal Sepsis ◽

Medical Records ◽

Early Onset ◽

Study Data ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Vitamin D Levels

Abstract Objective: To identify the association between maternal and umbilical cord vitamin D levels with suspects of early-onset of neonatal sepsis (EONS) in newborns from mothers with preterm premature rupture of membranes (PPROM).Methods: This is a retrospective cohort study conducted from January 2017 to Augusts 2018. Data was taken consecutively from medical records and previous study data at Dr. Cipto Mangunkusumo and Persahabatan Hospital, Jakarta.Results: From total of 72 infants from mothers with PPROM, 22 infants (31%) were EONS-suspected and 50 infants (69%) were not EONS-suspected. There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Conclusion: There was a significant association between maternal and umbilical cord vitamin D levels with EONS.Keywords: early-onset neonatal sepsis, preterm premature rupture of membrane, vitamin D, Abstrak Tujuan: Untuk mengetahui hubungan antara kadar vitamin D maternal dan tali pusat dengan risiko tejadinya Sepsis Neonatal Awitan Dini (SNAD) pada bayi dari ibu dengan Ketuban Pecah Dini (KPD).Metode: Desain penelitian kohort retrospektif secara consecutive sampling. Data diambil dari rekam medis dan data penelitian sebelumnya di Rumah Sakit Umum Pusat Nasional (RSUPN) Dr. Cipto Mangunkusumo dan Rumah Sakit Umum Pusat (RSUP) Persahabatan, Jakarta. Hasil: Dari 72 bayi yang dilahirkan dari ibu dengan KPD, 22 bayi (31%) diantaranya diduga mengalami SNAD, sedangkan 50 bayi lainnya tidak mengalami SNAD. Terdapat hubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD. Kesimpulan:Terdapathubungan yang bermakna antara kadar vitamin D maternal dan tali pusat dengan kejadian SNAD.Kata kunci: ketuban pecah dini, sepsis neonatal awitan dini, vitamin D

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