scholarly journals Patterns of placental pathology in preterm premature rupture of membranes

2013 ◽  
Vol 4 (3) ◽  
pp. 249-255 ◽  
Author(s):  
J. Armstrong-Wells ◽  
M. D. Post ◽  
M. Donnelly ◽  
M. J. Manco-Johnson ◽  
B. M. Fisher ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pathological Finding ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Exact Test ◽  
Preterm Premature Rupture ◽  
Chorionic Plate ◽  
Adverse Neonatal Outcomes ◽  
Insight Into

Inflammation is associated with preterm premature rupture of membranes (PPROM) and adverse neonatal outcomes. Subchorionic thrombi, with or without inflammation, may also be a significant pathological finding in PPROM. Patterns of inflammation and thrombosis may give insight into mechanisms of adverse neonatal outcomes associated with PPROM. To characterize histologic findings of placentas from pregnancies complicated by PPROM at altitude, 44 placentas were evaluated for gross and histological indicators of inflammation and thrombosis. Student's t-test (or Mann–Whitney U-test), χ2 analysis (or Fisher's exact test), mean square contingency and logistic regression were used when appropriate. The prevalence of histologic acute chorioamnionitis (HCA) was 59%. Fetal-derived inflammation (funisitis and chorionic plate vasculitis) was seen at lower frequency (30% and 45%, respectively) and not always in association with HCA. There was a trend for Hispanic women to have higher odds of funisitis (OR = 5.9; P = 0.05). Subchorionic thrombi were seen in 34% of all placentas. The odds of subchorionic thrombi without HCA was 6.3 times greater that the odds of subchorionic thrombi with HCA (P = 0.02). There was no difference in gestational age or rupture-to-delivery interval, with the presence or absence of inflammatory or thrombotic lesions. These findings suggest that PPROM is caused by or can result in fetal inflammation, placental malperfusion, or both, independent of gestational age or rupture-to-delivery interval; maternal ethnicity and altitude may contribute to these findings. Future studies focused on this constellation of PPROM placental findings, genetic polymorphisms and neonatal outcomes are needed.

Platelet indices in preterm premature rupture of membranes and their relation with adverse neonatal outcomes

2017 ◽  
Vol 44 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Betul Dundar ◽  
Burcu Dincgez Cakmak ◽  
Gulten Ozgen ◽  
Fatma Nurgul Tasgoz ◽  
Tugberk Guclu ◽  
...  
Keyword(s):  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Platelet Indices ◽  
Preterm Premature Rupture ◽  
Adverse Neonatal Outcomes

scholarly journals Neonatal Outcomes In Women With Preterm Premature Rupture of Membranes At Periviable Gestational Age

2022 ◽  
Author(s):  
Jacky Herzlich ◽  
Laurence Mangel ◽  
Ariel Halperin ◽  
Daniel Lubin ◽  
Ronella Marom
Keyword(s):  
Survival Rate ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Outcomes ◽  
High Survival ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Gestational Week

Abstract Purpose: To examine the outcomes of preterm infants born to women with preterm premature rupture of membranes at periviable gestational age.Methods: This is a retrospective study analyzing data on singleton deliveries complicated by prolonged premature rupture of membranes occurring before 24 weeks of gestation. Neonatal outcomes including birth weight, Apgar score, retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, hearing impairment and mortality were evaluated.Results: Ninety four preterm infants who were born after a prolonged premature rupture of membranes of at least 7 days were included in the study.Median gestational week at onset of membrane rupture was 27.1 ± 4.2 weeks (range 17 - 33) and median latency period in days was 16 ± 21.8 (range 7 - 105). We found that the survival rate to discharge within neonates born after prolonged rupture of membrane at gestational week less than 24 weeks is 79.2%. These neonates did not show an increased rate of major morbidities compared to neonates born following membrane rupture at gestational week 24 to 27. Conclusion: We described a high survival rate without major morbidities following prolonged preterm membrane rupture before viability.

scholarly journals The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes

2019 ◽  
Vol 09 (01) ◽  
pp. e67-e71 ◽  
Author(s):  
Anne Siegel ◽  
Robert Heine ◽  
Sarah Dotters-Katz
Keyword(s):  
Controlled Trial ◽  
Secondary Analysis ◽  
Standard Of Care ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Adverse Neonatal Outcomes ◽  
Alternative Antibiotic ◽  
The Impact

Objective A 7-day course of a penicillin (PCN) and macrolide is standard of care (SAR) in preterm premature rupture of membranes (PPROM). Data regarding alternative antibiotic regimens are limited. We sought to assess the impact of non-PCN regimens on neonatal outcomes. Study Design Secondary analysis of randomized controlled trial of antenatal magnesium sulfate. Singleton, nonanomalous pregnancies complicated by PPROM at > 24 weeks of gestation receiving the SAR were compared with women receiving a non-β-lactam regimen and a macrolide (NPCR). Primary outcome was a neonatal composite. Secondary outcomes included pregnancy latency, endometritis, and chorioamnionitis. Results A total of 949 women met inclusion criteria; 821(56%) received the SAR and 128(8.8%) received NPCR. Adjusted models did not demonstrate worse outcomes (AOR [adjusted odds ratio] = 0.50; 95% CI [confidence interval]: 0.22–1.11). Neonates receiving SAR were less likely to have bronchopulmonary dysplasia (BPD; p = 0.03) but more likely to have severe necrotizing enterocolitis (sNEC; p = 0.04). Risk for chorioamnionitis and median latency did not differ between groups but women receiving the SAR were less likely to get endometritis (AOR = 0.35; 95% CI: 0.14–0.91). Conclusions In this cohort, receiving NPCR in the setting of PPROM did not impact the overall risk of adverse neonatal outcomes or latency, but did increase the risk of endometritis. Alterations in individual neonatal morbidities suggest follow-up studies are needed.

scholarly journals Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34–36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

2020 ◽  
Vol 42 (11) ◽  
pp. 717-725
Author(s):  
Malú Flôres Ferraz ◽  
Thaísa De Souza Lima ◽  
Sarah Moura Cintra ◽  
Edward Araujo Júnior ◽  
Caetano Galvão Petrini ◽  
...  
Keyword(s):  
Gestational Age ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Management Group ◽  
Group I ◽  
Adverse Perinatal Outcomes ◽  
Group Ii

Abstract Objective To compare the type of management (active versus expectant) for preterm premature rupture of membranes (PPROM) between 34 and 36 + 6 weeks of gestation and the associated adverse perinatal outcomes in 2 tertiary hospitals in the southeast of Brazil. Methods In the present retrospective cohort study, data were obtained by reviewing the medical records of patients admitted to two tertiary centers with different protocols for PPROM management. The participants were divided into two groups based on PPROM management: group I (active) and group II (expectant). For statistical analysis, the Student t-test, the chi-squared test, and binary logistic regression were used. Results Of the 118 participants included, 78 underwent active (group I) and 40 expectant management (group II). Compared with group II, group I had significantly lower mean amniotic fluid index (5.5 versus 11.3 cm, p = 0.002), polymerase chain reaction at admission (1.5 versus 5.2 mg/dl, p = 0.002), time of prophylactic antibiotics (5.4 versus 18.4 hours, p < 0.001), latency time (20.9 versus 33.6 hours, p = 0.001), and gestational age at delivery (36.5 versus 37.2 weeks, p = 0.025). There were no significant associations between the groups and the presence of adverse perinatal outcomes. Gestational age at diagnosis was the only significant predictor of adverse composite outcome (x2 [1] = 3.1, p = 0.0001, R2 Nagelkerke = 0.138). Conclusion There was no association between active versus expectant management in pregnant women with PPROM between 34 and 36 + 6 weeks of gestation and adverse perinatal outcomes.

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