scholarly journals Impact of the new guidelines on the management of premature rupture of membranes for the prevention of late preterm birth: an 11-year retrospective study

2019 ◽  
Vol 47 (3) ◽  
pp. 341-346 ◽  
Author(s):  
Noémie Bouchet ◽  
Arnaud Joal ◽  
Angèle Gayet-Ageron ◽  
Marina Lumbreras Areta ◽  
Begoña Martinez de Tejada
Keyword(s):  
Expectant Management ◽  
Late Preterm ◽  
Elective Cesarean Section ◽  
Evidence Based ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Late Preterm Birth ◽  
Elective Cesarean ◽  
New Guidelines

Abstract Objectives To evaluate the number of late preterm (LPT) births (between 34 0/7 and 36 6/7 weeks) that could have been prevented if expectant management of preterm premature rupture of membranes (PPROM) had been applied according to new recommendations. Methods A retrospective cohort study included all births at one Swiss center between January 1, 2002 and December 31, 2012. Births were categorized using an adapted evidence-based classification. Two scenarios were considered: best scenario (maximum averted cases) and a conservative scenario (minimum averted cases). Results Among 2017 LPT births (5.0% of all deliveries; n=40,609), 1122 (60.6%) women had PPROM. Spontaneous labor occurred in 473 (42.2%) cases and 649 (57.8%) had induction of labor or an elective cesarean section. In the latter group, 44 (6.8%) had evidence-based indications for LPT delivery and 605 (83.2%) had non-evidence-based indications. Depending on the scenario, the rate of avoided LPT cases would have varied between 4.2% (95% confidence interval [CI]: 3.4–5.2) if the conservative scenario was applied, and 30% (95% CI: 28.0–32.0) for the best scenario. Conclusion Adoption of new guidelines for the management of PPROM will prevent a considerable number of LPT births and help decrease the adverse effects and potential disability associated with late preterm infants.

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.

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.

Preterm Premature Rupture of Membranes: Clinical Outcomes of Late-Preterm Infants

2009 ◽  
Vol 49 (1) ◽  
pp. 60-65 ◽  
Author(s):  
Julio Mateus ◽  
Karin Fox ◽  
Sangeeta Jain ◽  
Sunil Jain ◽  
Richard Latta ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Preterm Infants ◽  
Late Preterm ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Late Preterm Infants ◽  
Preterm Premature Rupture

Management of Late-Preterm Premature Rupture of Membranes

2013 ◽  
Vol 68 (2) ◽  
pp. 89-91 ◽  
Author(s):  
David P. van der Ham ◽  
Jantien L. van der Heyden ◽  
Brent C. Opmeer ◽  
Antonius L. M. Mulder ◽  
Rob M. J. Moonen ◽  
...  
Keyword(s):  
Late Preterm ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

scholarly journals Treatment of Preterm Premature Rupture of Membranes with Oligo-/Anhydramnion Colonized by Multiresistant Bacteria with Continuous Amnioinfusion and Antibiotic Administrations through a Subcutaneously Implanted Intrauterine Port System: A Case Report

2015 ◽  
Vol 42 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Michael Tchirikov ◽  
Zhaxybay Zhumadilov ◽  
Andreas Suhartoyo Winarno ◽  
Roland Haase ◽  
Jörg Buchmann
Keyword(s):  
Good Condition ◽  
Expectant Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Antenatal Corticosteroids ◽  
Amniotic Cavity ◽  
Preterm Premature Rupture ◽  
System A ◽  
Multiresistant Bacteria ◽  
Port System

Bacterial infection is one of the main causes of preterm premature rupture of membranes (PPROM) leading to preterm delivery, pulmonary hypoplasia, sepsis and joint deformities. Expectant management, broad-spectrum antibiotics and antenatal corticosteroids are routinely used in this condition with very limited success to prevent bacteremia, chorioamnionitis, funisitis and intra-amniotic infection syndrome. Here, we report a case in which we attempted to treat PPROM at 26+3 weeks of gestation with anhydramnion colonized by multiresistant Klebsiella. A perinatal port system was implanted subcutaneously at 28+0 weeks of gestation, enabling long-term continuous lavage of the amniotic cavity with a hypotonic aqueous composition similar to human amniotic fluid combined with intra-amniotic antibiotic application. The patient gave birth to a preterm female infant at 31+1 weeks without any signs of infection. The girl was discharged with a weight of 2,730 g in very good condition. In the follow-up examinations at 5 months and 1 year of age, there was no apparent neurological disturbance, developmental delay or Klebsiella colonization.

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