Latency Period after Preterm Premature Rupture of Membranes: Singletons versus Twins

2021 ◽  
Author(s):  
Nigel Madden ◽  
Maria Andrikopoulou ◽  
Eve Overton ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Clinical Outcomes ◽  
Latency Period ◽  
Expectant Management ◽  
Small Sample ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Neurodevelopmental Outcomes ◽  
Preterm Premature Rupture

Objective Several studies have evaluated the differences in duration of latency and clinical outcomes between singleton and twin pregnancies after preterm premature rupture of membranes (PPROM); however, these data are limited to single-institution analyses and based on small sample sizes. The aim of this study was to assess differences in latency and clinical outcomes in singletons versus twin gestations affected by PPROM in a large, diverse cohort of women. Study Design This is a secondary analysis of a multicenter trial of magnesium for neuroprotection in women at high risk of preterm birth. Our study included women with PPROM ≥ 24 weeks with singleton and twin gestations. We compared singleton versus twin gestation and our primary outcome was duration of latency after PPROM. Secondary outcomes included selected perinatal and neonatal outcomes including long-term neurodevelopmental outcomes. We fit a linear regression model to assess independent risk factors for latency duration. Results Our study included 1,753 women, 1,602 singleton gestations (91%) and 151 twin gestations (9%). The median latency period was significantly shorter in twins (4 [interquartile range, IQR: 1–10] vs. 7 [IQR: 3–16] days, p < 0.001) and gestational age at delivery was significantly earlier (29.3 vs. 30.1 weeks, p = 0.001). Twins were more likely to develop neonatal sepsis (20.1 vs. 13.4%, p = 0.004), but rates of chorioamnionitis and abruption did not differ. Twins were more likely to suffer from adverse short-term neonatal outcomes, had higher rates of neonatal demise (7.9 vs. 3.8%, p = 0.002), and had higher rates of cerebral palsy (7.3 vs. 3.7, p = 0.005). When adjusting for confounders, twin gestation remained an independent risk factor for shorter latency (p < 0.001). Conclusion Twin gestations affected by PPROM had shorter latency, earlier delivery, and higher rates of short- and long-term morbidity. Despite having longer latency, singleton gestations did not have higher rates of complications associated with expectant management. Key Points

scholarly journals Evaluation of maternal and neonatal outcomes in the case of preterm premature rupture of membranes and their relationship to prenatal maternal indicators: Across -sectional descriptive study

2020 ◽  
Vol 10 (6) ◽  
pp. 55
Author(s):  
Mirfat Mohamed Labib El-Kashif ◽  
Azza Mohamed Fathy ◽  
Howaida Amin Hassan Fahmy Elsaba
Keyword(s):  
Neonatal Outcome ◽  
Expectant Management ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
Preterm Premature Rupture ◽  
Management Protocol ◽  
Maternal And Neonatal Outcomes

Background and aim: Preterm premature rupture of membranes is one of the most important causes of pregnancy complication and a significant role in the occurrence of perinatal morbidity and mortality. The present study aims to evaluate the maternal and neonatal outcomes in the case of preterm premature rupture of membranes and their relationship to prenatal maternal indicators.Subjects and methods: A cross-sectional descriptive design was used to evaluate 68 pregnant women with a gestational age of 32 to before 37 weeks, and singleton pregnancy complicated by preterm premature rupture of membranes who fulfilled the inclusion criteria. The data were collected by convenience sampling using standardized tools.Results: A linear correlation was used to show a correlation between maternal clinical indicators with the predictive maternal and neonatal outcome using a Spearman Rho correlation coefficient. The most significant neonatal outcomes are neonatal intensive care unit admission, neonatal respiratory distress syndrome, and early neonatal sepsis. More than two-thirds of the studied women had expectant management, and less than one-fourth of them have postnatal sepsis.Conclusion and recommendation: The prenatal maternal indicators are the significant values for maternal and neonatal outcome in case of preterm premature rupture of membranes, so A further larger prospective study is recommended to demonstrate the difference in incidence, management protocol of preterm premature rupture of the membranes in the delivery and maternity health care services.

scholarly journals The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes

2014 ◽  
Vol 6 (1) ◽  
pp. 28-32
Author(s):  
Nasira Tasnim ◽  
Ghazala Mahmud ◽  
Saba Fatima
Keyword(s):  
Controlled Trial ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Management Control ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Prolongation

ABSTRACT Objective To evaluate the role of transabdominal amnioinfusion in improving the latency period and perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (PPROM). Materials and methods A randomized controlled trial was carried out at MCH Centre, Unit I, PIMS, Islamabad, from Jan 2008 to Dec 2008. Sixty women with singleton pregnancies between 28 and 32 completed weeks of gestation, complicated with PPROM was randomly allocated into two groups viz transabdominal amnioinfusion (amnioinfusion group) and expectant management (control group), within 24 hours of admission. Results The demographic characteristics were comparable in both the groups. Amnioinfusion group showed significant improvement in PPROM to delivery interval (18.47 ± 6.699 vs 8.93 ± 4.741 days; p = 0.001), neonatal birth weight (p = 0.019) and Apgar scores at 1 and 5 minutes (p = 0.007 for 1 minute and p = 0.012 for 5 minutes). There was less frequency of respiratory distress syndrome (p = 0.032), neonatal sepsis (p = 0.020) and neonatal jaundice (p = 0.002) in the amnioinfusion group. Fewer neonates were admitted to NICU (p = 0.010) and higher survival rate was found in amnioinfusion group (p = 0.023). Conclusion The treatment with transabdominal amnioinfusion in pregnancies complicated with PPROM resulted in significant prolongation of pregnancy and better neonatal outcomes as compared to women who were managed with traditional expectant management. How to cite this article Fatima S, Tasnim N, Mahmud G. The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes. J South Asian Feder Obst Gynae 2014;6(1):28-32.

scholarly journals Perinatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes during the late preterm period

2021 ◽  
Author(s):  
Hayan Kwon ◽  
Suk Ho Kang ◽  
Hyun Sun Ko ◽  
Ja Young Kwon ◽  
Han-sung Kwon ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Expectant Management ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Maternal Sepsis

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.

Long-Term Amnioinfusion through an Intrauterine Catheter in Preterm Premature Rupture of Membranes before 26 Weeks of Gestation: A Retrospective Multicenter Study

2021 ◽  
pp. 1-6
Author(s):  
Tomasz Goździewicz ◽  
Magdalena Rycel-Dziatosz ◽  
Klaudyna Madziar ◽  
Tomasz Szczapa ◽  
Witold Kędzia ◽  
...  
Keyword(s):  
Latency Period ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Newborn Outcomes ◽  
Management Group ◽  
Retrospective Multicenter Study

<b><i>Introduction:</i></b> The objective of this study was to elucidate the efficacy of long-term amnioinfusion on perinatal outcomes in patients with preterm premature rupture of membranes (PPROM) before 26 weeks’ gestation. <b><i>Material:</i></b> A total of 31 patients with PPROM at a periviable gestational age (21 + 0–25 + 0 weeks) were enrolled. Long-term amnioinfusion was performed in 22 patients, and 9 patients did not receive amnioinfusion. Data were collected retrospectively from 2 clinical sites between January 2017 and March 2019. <b><i>Results:</i></b> In the medical management group, there was a significantly higher rate of chorioamnionitis compared to the long-term amnioinfusion group (89 vs. 15%, <i>p</i> = 0.001). The latency period between PPROM and delivery was higher in the amnioinfusion group (median, 5.5 vs. 3 weeks, <i>p</i> = 0.04). The frequency of bronchopulmonary dysplasia was higher in the control group compared to the amnioinfusion group (89 vs. 40%, <i>p</i> = 0.03). The rates of other neonatal complications were similar in both groups. <b><i>Conclusions:</i></b> Long-term amnioinfusion through an intrauterine catheter in PPROM before 26 weeks’ gestation may improve pregnancy and newborn outcomes.

Perinatal outcomes after previable preterm premature rupture of membranes before 24 weeks of gestation

2018 ◽  
Vol 46 (5) ◽  
pp. 555-565 ◽  
Author(s):  
Verena Kiver ◽  
Vinzenz Boos ◽  
Anke Thomas ◽  
Wolfgang Henrich ◽  
Alexander Weichert
Keyword(s):  
Survival Rate ◽  
Pregnancy Termination ◽  
Treatment Options ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Mortality And Morbidity ◽  
Membrane Rupture ◽  
Preterm Premature Rupture

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.

scholarly journals Outcomes of prolonged preterm premature rupture of the membrane: a report of six cases

2018 ◽  
Vol 8 (1) ◽  
pp. 329
Author(s):  
Asha Dixit
Keyword(s):  
Maternal Morbidity ◽  
Complete Blood Count ◽  
Clinical Investigation ◽  
Present Report ◽  
Latency Period ◽  
Expectant Management ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Foetal Mortality ◽  
Litmus Test

Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.

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