Shigellosis complicating preterm premature rupture of membranes resulting in congenital infection and preterm delivery

2002 ◽  
Vol 100 (5) ◽  
pp. 1063-1065 ◽  
Author(s):  
A REBARBER
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.


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.


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

2015 ◽  
Vol 21 (4) ◽  
pp. 161-170
Author(s):  
Ieva Daunoravičienė ◽  
Rūta Lenkutienė ◽  
Audrė Musteikytė ◽  
Diana Ramašauskaitė

Background. The study investigates the influence of the length of membrane rupture period among pregnant women with preterm premature rupture of membranes (PPROM) between the 32nd and 34th weeks of gestation on the development of chorioamnionitis and the congenital infection of a newborn. It seeks to ascertain the values of indicators in mother’s blood that enable to predict chorioamnionitis and funisitis for mothers, and congenital infection for newborns. Materials and methods. A retrospective study of case records of women with PPROM at 32 (32 w. + 0 d)–34 (33 w. + 6 d) weeks of gestation and their newborns was performed. Two comparative groups were made: 1) of women who had funisitis and / or chorioamnionitis with or without deciduitis and 2) of women having no proved inflammation (according to the results of histological examination of placentae). Analogically, comparative groups were made of their newborns: those who had diagnosis of congenital infection and those who had no infection. The duration of membrane rupture period and the blood markers were investigated in all the groups. Results. The study included 135 women. Duration of the membrane rupture period lasted 85.17 ± 84.72 hrs in the group of women who had histological inflammation, and 40.06 ± 56.57 hrs in the group with no inflammation, P = 0.01, AUC = 0.735; the critical membrane rupture period value for developing intrauterine infection by the Youden index was 43.7 hrs. The corresponding maternal CRP values (mg/l) were 25.85 ± 40.27 vs. 5.23 ± 7.88 (P = 0.01, AUC = 0.6), the Youden index 4.6 mg/l. For the mothers of the newborns diagnosed with infection, the duration of the membrane rupture period was 55.95 ± 65.04 hrs, for the mothers of the newborns without congenital infection it was 40.25 ± 73.71 hours. Respectively, CRP values for the mothers of newborns averaged 12.25  ±  22.14  mg/l vs. 4.8 ± 4.82 mg/l (P = 0.005). Conclusions. Longer membrane rupture period and higher maternal CRP are correlated with inflammatory changes in the placenta and umbilical cord, thus they can be used as the prognostic indicators of intrauterine infection. When the duration of the membrane rupture period lasts ≥44 hrs, the risk of chorioamnionitis and funisitis increases five times; when the maternal serum CRP is higher than 5 mg/l, funisitis / chorioamnionitis is twice more frequent than at lower than 5 mg/l CRP values.


2019 ◽  
Author(s):  
Lida Moghaddam-Banaem ◽  
Shiva Niyaty ◽  
Hadis Sourinejad ◽  
Samira Mokhlesi

Abstract Objectives We aimed to evaluate the association of metabolic syndrome (MetS), its components and lipid profile in mid-pregnancy with preterm delivery and preterm premature rupture of membranes (PPROM).Methods This prospective cohort study was conducted on 203 pregnant women between 24-28 weeks of gestation, undergoing the gestational diabetes screening test with 50 gr glucose challenge test (GCT). Fasting serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high -density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were measured during the week after GCT assessment. Information on the participants' pre-pregnancy weight, demographic/ reproductive characteristics, and height and blood pressure (BP) measurements were documented at baseline entry into the study. Metabolic syndrome was defined as the co-existence of 3 or more of the following criteria: Body mass index (BMI) before pregnancy≥30 kg/m2, BP≥130/85 mmHg, GCT≥140mg/dl, TG≥150mg/dl, and HDL-C≤50mg/dl. All participants were followed through routine prenatal care, up to delivery. Any deliveries or rupture of membranes of less than or equal to weeks of pregnancy, were considered preterm delivery and PPROM respectively. Statistical analysis was performed by SPSS V.20, and p-value of less than 0.05 was considered significant.Results MetS was detected in 10 (4.9%) of participants. Logistic regression analysis showed HDL-C levels, and hypertension had significant effects on preterm delivery occurrence [(OR: 0.952, 95%CI: 0.910_0.995), (OR: 1.629, 95% CI: 1.554_1.709) respectively], but no statistically significant results were found for PPROM.Conclusions Low HDL-C levels and hypertension in mid-pregnancy may increase the occurrence of preterm deliveries, indicating that MetS and its components should be monitored more closely in pregnancy.


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