295 How Is the Latency Period Affected by Cervical Colonization with Gonorrhea or Chlamydia in Preterm Premature Rupture of Membranes (Pprom)?

1993 ◽  
Vol 168 (1) ◽  
pp. 379
2018 ◽  
Vol 46 (5) ◽  
pp. 555-565 ◽  
Author(s):  
Verena Kiver ◽  
Vinzenz Boos ◽  
Anke Thomas ◽  
Wolfgang Henrich ◽  
Alexander Weichert

Abstract Objective: A current descriptive assessment of perinatal outcomes in pregnancies complicated by previable preterm premature rupture of membranes (pPPROM) at <24 weeks of gestation, after expectant treatment. Study design: Maternal and short-term neonatal data were collected for patients with pPPROM. Results: Seventy-three patients with 93 fetuses were hospitalized with pPPROM at 15–24 weeks’ gestation. Among these patients, 27.4% (n=20) chose pregnancy termination, 27.4% (n=20) miscarried and 45.2% (n=33) proceeded to live births. After a median latency period of 38 days, ranging from 1 to 126 days, 24 singletons and 20 multiples were live-born, of whom 79.5% (n=35) survived the perinatal period. The main neonatal sequelae were pulmonary hypoplasia (29.5%; n=13), connatal infection (56.8%; n=25), intraventricular hemorrhage (25%; n=11; resulting in five neonatal deaths) and Potter’s syndrome (15.9%; n=7). Nine newborns died, within an average of 2.8 days (range, 1–10 days). The overall neonatal survival rate was 51.5% – including miscarriages but not elective terminations. The intact survival rate was 45.5% of all live-born neonates. Conclusions: Even with limited treatment options, overall neonatal survival is increasing. However, neonatal mortality and morbidity rates remain high. The gestational age at membrane rupture does not predict neonatal outcome.


2021 ◽  
Author(s):  
Shuwei Zhou ◽  
Yajun Yang ◽  
XiaoYan Zhang ◽  
Xiaoling Mu ◽  
Quan Quan ◽  
...  

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.


2021 ◽  
Vol 29 (1) ◽  
pp. 13-19
Author(s):  
Erdem Şahin ◽  
Yusuf Madendağ

Objective The aim of the present study was to evaluate the impact of residual anhydramnios following preterm premature rupture of membranes (PPROM) on respiratory distress syndrome (RDS) after the pregnancy was expectantly managed. Methods This study was retrospectively conducted at Erciyes University Medical School, Turkey. It assessed women with singleton pregnancies admitted to the hospital between 2010 and 2020 for expectant management of PPROM between 24th and 28th gestational weeks. The patients were divided into three groups as follows: (1) anhydramnios, (2) oligohydramnios, (3) normal amniotic fluid volume (AFV). Main outcome measure was as follows: The first evaluation was AFV at admission and the primary outcome was a neonatal RDS. Adjusted odds ratios (aOR) and 95% confidence interval (CI) for RDS were calculated for each AFV-at-presentation adjusting for gestational age (GA) at PPROM, GA at delivery, latency period, birth-weight percentile, cesarean birth, and chorioamnionitis. Results Of the 440 women with PPROM, 261 fulfilled the inclusion criteria. There were 125 (47.8%) with normal AFV, 71 (27.3%) with oligohydramnios, and 65 (24.9%) with anhydramnios at admission. The maternal demographic characteristics were similar among the groups. Birth weight was significantly different among the groups. RDS was highest in the anhydramnios group (64.6%). Decreased AFV was not associated with RDS in either oligohydramnios or anhydramnios at presentation. A GA at PPROM, latency period >30 days, and cesarean delivery were co-factors in the outcome. Conclusion Our results indicated that oligohydramnios and anhydramnios were not associated with RDS risk, but GA at PPROM and delivery, latency period, and cesarean delivery were independently associated with the RDS risk.


2010 ◽  
Vol 283 (4) ◽  
pp. 707-710 ◽  
Author(s):  
Gidon Test ◽  
Amalia Levy ◽  
Arnon Wiznitzer ◽  
Moshe Mazor ◽  
Gershon Holcberg ◽  
...  

Author(s):  
Jameela Diraviyam M. V. ◽  
Lalithambica Karunakaran

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for approximately one third of all preterm births. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6daysMethods: A descriptive study was conducted on 141 antenatal patients between 28 to 36weeks+6days with PPROM admitted to Department of Obstetrics and Gynecology, Government TD Medical College, Alappuzha, Kerala, India from September 2014 to September 2015. After establishing the diagnosis of PPROM patients were monitored and Maternal and perinatal outcomes were studied.Results: 77% patients had late PPROM. 60% of early PPROM latency period >24 hrs and were managed conservatively till 34 weeks. 18% had chorioamnionitis and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period <24 hrs and only 4% had chorioamnionitis.18.5% babies in this group had hyperbilirubinemia. There was statistically significant association between latency period and perinatal complications (p=0.001). RDS was 33% in latency period <24hrs, 18% in >24hrs and sepsis was 36% in >24hrs and 10% in <24hrs.Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis. 


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