Outcomes in oligohydramnios: the role of etiology in predicting pulmonary morbidity/mortality

2018 ◽  
Vol 46 (8) ◽  
pp. 948-950 ◽  
Author(s):  
Ashley Hesson ◽  
Elizabeth Langen
Keyword(s):  
Pregnancy Termination ◽  
Respiratory Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Renal Anomalies ◽  
Mortality And Morbidity ◽  
Respiratory Mortality ◽  
Live Births ◽  
Preterm Premature Rupture

Abstract Objective Early-onset oligohydramnios is typically secondary to renal-urinary anomalies (RUA) or preterm premature rupture of membranes (PPROM). We compared neonatal pulmonary outcomes between these etiologies. Methods We conducted a retrospective cohort study of women with oligohydramnios identified before 24 completed weeks of gestation attributed to either PPROM or RUA. Patients were excluded if other fetal anomalies were noted. Respiratory morbidity was assessed by the need for oxygen at 36 corrected weeks or at hospital discharge. Results Of 116 eligible patients, 54 chose elective pregnancy termination. A total of 39.5% of PPROM (n=17/43) and 36.8% of RUA (n=7/19) pregnancies experienced pre-viable loss (P=1.00). Significantly fewer PPROM live births resulted in neonatal mortality (26.9% vs. 75.0%, P<0.01). There was no difference in respiratory morbidity (57.9% vs. 66.6%, P=1.00). The collective incidence of respiratory mortality and morbidity was not different between etiologies (P=0.06). Conclusion This analysis suggests that the prognoses for oligohydramnios due to pre-viable PPROM vs. renal anomalies are similarly grave, though RUA infants experienced a higher rate of neonatal respiratory mortality.

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.

The role of continuous fetal monitoring in the management of preterm premature rupture of membranes

2008 ◽  
Vol 21 (5) ◽  
pp. 301-304 ◽  
Author(s):  
Janae M. Davis ◽  
Michael A. Krew ◽  
Prabhcharan Gill ◽  
Karl M. Nelson ◽  
Michael P. Hopkins
Keyword(s):  
Fetal Monitoring ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Trends in Spontaneous and Medically Indicated Preterm Birth in Twins versus Singletons: A California Cohort 2007 to 2011

2021 ◽  
Author(s):  
Amen Ness ◽  
Jonathan A. Mayo ◽  
Yasser Y. El-Sayed ◽  
Maurice L. Druzin ◽  
David K. Stevenson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Population Based ◽  
Birth Certificates ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Live Births ◽  
Preterm Premature Rupture ◽  
Key Points ◽  
Hospital Discharge Records

Objective The study aimed to describe preterm birth (PTB) rates, subtypes, and risk factors in twins compared with singletons to better understand reasons for the decline in PTB rate between 2007 and 2011. Study Design This was a retrospective population-based analysis using the California linked birth certificates and maternal-infant hospital discharge records from 2007 to 2011. The main outcomes were overall, spontaneous (following spontaneous labor or preterm premature rupture of membranes), and medically indicated PTB at various gestational age categories: <37, <32, and 34 to 36 weeks in twins and singletons. Results Among the 2,290,973 singletons and 28,937 twin live births pairs included, overall PTB <37 weeks decreased by 8.46% (6.77–6.20%) in singletons and 7.17% (55.31–51.35%) in twins during the study period. In singletons, this was primarily due to a 24.91% decrease in medically indicated PTB with almost no change in spontaneous PTB, whereas in twins indicated PTB declined 7.02% and spontaneous PTB by 7.39%. Conclusion Recent declines in PTB in singletons appear to be largely due to declines in indicated PTB, whereas both spontaneous and indicated PTB declined in twins. Key Points

Management of born too soon preterm birth complicated by preterm premature rupture of membranes

2016 ◽  
pp. 58-64
Author(s):  
O.B. Malanchuk ◽  
◽  
V.P. Lakatosh ◽  
O.U. Kostenko ◽  
M.I. Antonuk ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Statistical Analysis ◽  
Pregnant Women ◽  
Neonatal Mortality ◽  
Perinatal Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Mortality And Morbidity ◽  
Pregnancy And Childbirth ◽  
Preterm Premature Rupture

In Ukraine, each year born about 1,000 children ELBW, representing 0.3% of all newborns. The survival of infants with ELBW in our country has a slow upward trend and does not exceed 50%. Infants with ELBW have the highest risk of death and are the group most at risk for the development of chronic diseases of the respiratory and nervous systems and sensory apparatus and associated disability. Considering the growth of the number of children at private ELBW on the background PPROM, high perinatal morbidity and infant mortality, reduced health and reproductive capacity of women becoming urgency tactics of pregnancy and labor with premature rupture of membranes. The objective: perynatalniyh reduce complications in terms of 22-28 weeks of pregnancy complicated by premature rupture of membranes based on developing the tactics of pregnancy and childbirth. Patients and methods. To reduce perinatal complications analyzed the effect of different methods of pregnancy and childbirth on the state of newborns in gestational age 22-28 weeks against the backdrop of premature discharge of amniotic fluid. The control group consisted of 56 women who had less than a day anhydrous term. In the study group applied expectant tactics of anhydrous long term. Depending on the length of the term of anhydrous main group was divided into 2 subgroups. Sub-IA amounted to 86 pregnant women with anhydrous period of 5 days, and IP subgroup totaled 64 pregnant women with anhydrous period of 25 days. Statistical analysis of the results was performed using Microsoft Excel. Probability difference calculated by Student’s t-criterion. Results. Аnalyzing the structure and frequency of obstetric and perinatal complications in women in the period 22-28 weeks of pregnancy with different duration waterless terms, different terms of delivery proved the effectiveness of the tactics of delivery, which is used in perinatal centers m. Kyiv. This correlates with clinical data - statistical analysis of indicators of neonatal mortality and morbidity. Conclusion. Оf the research found that the rates of neonatal mortality and morbidity affecting: duration of anhydrous interval, gestational period, methods of delivery. Long expectant tactics leads to a real reduction of RDS, but an increase in the incidence of chorioamnionitis and neonatal infection. Therefore, wait-recommended tactics for 5 days, followed by delivery of women. At 22-27 weeks of pregnancy delivery path has no impact on rates of neonatal morbidity. The advantage in the delivery of women in the period 27-28 weeks, especially in the immature cervix and pelvic peredlezhenni fetal provided cesarean section. Key words: born too soon preterm birth, preterm premature rupture of membranes, pregnancy, method of delivery, birth with extremely low body weight.

THE ROLE OF uPAR,ST2,IL-33,IL-6 FOR THE DIAGNOSIS OF PRETERM PREMATURE RUPTURE OF MEMBRANES

2013 ◽  
Vol 10 (4) ◽  
pp. 231-235
Author(s):  
Yasemin Cekmez ◽  
Doga Ocal ◽  
Enis Ozkaya ◽  
Tuncay Kucukozkan ◽  
Ferhat Cekmez
Keyword(s):  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Role of the vaginal microbiota in preterm premature rupture of membranes

2020 ◽  
Vol 1_2020 ◽  
pp. 20-25
Author(s):  
Guseinova G.E. Guseinova ◽  
Khodzhaeva Z.S. Khodzhaeva ◽  
Muravyeva V.V. Muravyeva ◽  
Keyword(s):  
Vaginal Microbiota ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

“EVALUATION OF THE PREDICTIVE ROLE OF C REACTIVE PROTEIN IN MATERNAL OUTCOME OF PRETERM PREMATURE RUPTURE OF MEMBRANES (PPROM)”

2021 ◽  
pp. 70-72
Author(s):  
R.K. Talukdar ◽  
Nanthini Devi ◽  
Tanma Saikia Das
Keyword(s):  
Wound Infection ◽  
Maternal Outcome ◽  
C Reactive Protein ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Reactive Protein ◽  
Preterm Premature Rupture ◽  
Group I

AIMS AND OBJECTIVE: To evaluate the role of maternal C-reactive protein(CRP) as a predictor of maternal outcomes- chorioamnionitis, Puerperal pyrexia, wound infection, PPH, URTI and UTI in preterm premature rupture of membranes(PPROM). An institutional based prospective case control study was METHODS: conducted in Gauhati Medical College and Hospital from 1st July 2019 to 31st June 2020.This study was conducted on total 280 antenatal women, 140 cases of PPROM (Group I) and 140 cases of normal term pregnancy (Group II) were used as a control. Cases were selected by sampling who fullled the inclusion and exclusion criteria. The data collected in the study was analysed statistically using descriptive statistics and analysis was carried out by Fischer's exact test. Results were tabulated and analysed statistically using SPSS version 21.0. RESULTS: A total of 280 mothers participated in this study which yields 100% response rate. Among the study groups more complications were observed in Cases group (Group I). The most common maternal complications were found to be puerperal pyrexia (6.40%) followed by wound infection (5.00%) in cases group where as in control groups puerperal pyrexia was seen in 3.60% of mothers and wound infection in 2.10% mothers of control group (Group II). Chorioamnionitis was seen only in cases group (Group I) among 4 patients (2.9%) and all of these had CRP>20mg/L. There was no maternal mortality recorded. CRP has sensitivity 100% (95% CI, 85.18% to 100.00%) and specicity 65.81% (95% CI, 56.47% to 74.33%) and PPV 36.51% (95% CI, 30.90% to 42.51%) and NPV 100%. Thus we can utilize CRP as a predictive tool for maternal complications in PPROM mothers. CONCLUSIONS AND RECOMMENDATION: Antenatal diagnosis of preterm PROM by identifying risk factors is an important tool in the management of PPROM. CRP is early and reliable indicator of maternal complications with high sensitivity and high negative predictive value. Maternal serum CRP at admission is the most accurate infectious marker for predicting the maternal outcome that is currently in routine use. It may serve as a noninvasive screening tool to distinguish between women with PPROM who are at high or at low risk for adverse maternal outcome.`

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