scholarly journals Association between latency period and perinatal outcomes after preterm premature rupture of membranes at 32–37 weeks of gestation: a perinatal registry-based cohort study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Marie Bitenc ◽  
Lea Ovsenik ◽  
Miha Lučovnik ◽  
Ivan Verdenik ◽  
Lilijana Kornhauser Cerar
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Maternal Body Mass Index ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Antenatal Corticosteroids ◽  
Preterm Premature Rupture ◽  
Group B

Abstract Objectives To investigate association between latency after preterm premature rupture of membranes (PPROM) and perinatal outcomes at moderately and late preterm gestation. Methods National perinatal registry-based cohort study using data for the period 2013–2018. Singleton pregnancies with non-malformed fetuses in cephalic presentation complicated by PPROM at 32+0–36+6 weeks were included. Associations between latency period and perinatal mortality, neonatal respiratory distress syndrome (RDS), early onset neonatal infection (EONI), and cesarean section were assessed using multiple logistic regression, adjusting for potential confounders (labor induction, maternal body-mass-index, maternal age, antenatal corticosteroids, and small-for-gestational-age). p<0.05 was considered statistically significant. Results Of 3,017 pregnancies included, 365 (12.1%) had PPROM at 32+0–33+6 weeks and 2,652 (87.9%) at 34+0–36+6 weeks. Among all cases, 2,540 (84%) had latency <24 h (group A), 305 (10%) 24–47 h (group B), and 172 (6%) ≥48 h (group C). Longer latency was associated with higher incidence of EONI (adjusted odds ratio [aOR] 1.350; 95% confidence interval [CI] 0.900–2.026 for group B and aOR 2.500; 95% CI 1.599–3.911 for group C) and higher rate of caesarean section (aOR 2.465; 95% CI 1.763–3.447 for group B and aOR 1.854; 95% CI 1.172–2.932 for group C). Longer latency was not associated with rates of RDS (aOR 1.160; 95% CI 0.670–2.007 for group B and aOR 0.917; 95% CI 0.428–1.966 for group C). Conclusions In moderately to late PPROM, increased latency is associated with higher risk of EONI and cesarean section with no reduction in RDS.

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 Perinatal Outcomes of Twin Pregnancies With Preterm Premature Rupture of the Membranes at 24–34 Weeks’ Gestation

2021 ◽  
Author(s):  
Shuwei Zhou ◽  
Yajun Yang ◽  
XiaoYan Zhang ◽  
Xiaoling Mu ◽  
Quan Quan ◽  
...  
Keyword(s):  
Neonatal Death ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Factors Associated ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes ◽  
Twin Pregnancies

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.

scholarly journals Maternal and perinatal outcome in preterm premature rupture of membranes

2017 ◽  
Vol 6 (6) ◽  
pp. 2498
Author(s):  
Jameela Diraviyam M. V. ◽  
Lalithambica Karunakaran
Keyword(s):  
Perinatal Mortality ◽  
Conservative Management ◽  
Perinatal Outcome ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Perinatal Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and is responsible for approximately one third of all preterm births. Objective of present study was to analyse the maternal and perinatal outcome of PPROM patients between 28 to 36 weeks +6daysMethods: A descriptive study was conducted on 141 antenatal patients between 28 to 36weeks+6days with PPROM admitted to Department of Obstetrics and Gynecology, Government TD Medical College, Alappuzha, Kerala, India from September 2014 to September 2015. After establishing the diagnosis of PPROM patients were monitored and Maternal and perinatal outcomes were studied.Results: 77% patients had late PPROM. 60% of early PPROM latency period >24 hrs and were managed conservatively till 34 weeks. 18% had chorioamnionitis and immediate termination of pregnancy. 73% of newborns in this group needed admission due to complications of prematurity like RDS (54.54%). Perinatal mortality (2.12%) was due to sepsis. 80% of late PPROM had latency period <24 hrs and only 4% had chorioamnionitis.18.5% babies in this group had hyperbilirubinemia. There was statistically significant association between latency period and perinatal complications (p=0.001). RDS was 33% in latency period <24hrs, 18% in >24hrs and sepsis was 36% in >24hrs and 10% in <24hrs.Conclusions: The most common cause of perinatal mortality in early PPROM is prematurity and its complications. Hence conservative management to prolong pregnancy is recommended under strict monitoring for evidence of chorioamnionitis. At the earliest evidence of chorioamnionitis termination irrespective of gestational age is warranted. In late PPROM, perinatal outcome is good. So, termination is advised as conservative management shall add to the fetal and maternal morbidity due to sepsis. 

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 The effects of oligohydramnios on perinatal outcomes after preterm premature rupture of membranes

2021 ◽  
Vol 29 (1) ◽  
pp. 27-32
Author(s):  
Subhashini Ladella ◽  
David Lee ◽  
Fatemeh Abbasi ◽  
Brian Morgan
Keyword(s):  
Amniotic Fluid ◽  
Medical Center ◽  
Predictor Variable ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Apgar Scores ◽  
Preterm Premature Rupture ◽  
Adverse Perinatal Outcomes

Objective Amniotic fluid plays a vital protective role in fetal growth and development. Low amniotic fluid index (AFI) during pregnancy increases risk of adverse perinatal outcomes. Prior studies reported association of oligohydramnios (AFI<5 cm) with shorter latency period and inconsistent correlation with chorioamnionitis after preterm premature rupture of membranes (PPROM). We studied effects of oligohydramnios on perinatal outcomes after PPROM. Methods A retrospective cross-sectional study was performed at our medical center on women with PPROM between 23 to 34 weeks during 2014 to 2016. The primary predictor variable was AFI of <5 cm or ≥5 cm in relationship to perinatal outcomes. Results From a total of 117 PPROM cases reviewed, 46 women had AFI<5 cm and 71 had AFI≥5 cm. Length of stay (LOS) in neonatal intensive care unit (NICU) was 42 days for AFI<5 cm versus 26.5 days for AFI>5 cm (p<0.007). The mean neonatal Apgar scores at 1 and 5 minutes (5.2 and 7.4 respectively) were lower in the AFI<5 cm group compared to AFI≥5 cm (6.9 at 1 minute and 8.4 at 5 minutes, p<0.001). Conclusion Oligohydramnios after PPROM is associated with adverse perinatal outcomes such as lower Apgar scores and longer LOS in the NICU. No association was observed with latency period and chorioamnionitis.

scholarly journals Perinatal Outcomes Associated with Latency in Late Preterm Premature Rupture of Membranes

2021 ◽  
Vol 18 (2) ◽  
pp. 672
Author(s):  
Eui Kyung Choi ◽  
So Yeon Kim ◽  
Ji-Man Heo ◽  
Kyu Hee Park ◽  
Ho Yeon Kim ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Late Preterm ◽  
Premature Rupture ◽  
Antenatal Corticosteroids ◽  
Preterm Premature Rupture ◽  
Antenatal Steroids ◽  
Significant Difference

This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006–2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery ≥72 h vs. immediate delivery <72 h). Data were compared among 345 women (expectant, n = 39; immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p < 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (≥72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM.

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.

scholarly journals Cefotaxime vs Ceftriaxone for the Management of Preterm Premature Rupture of Membranes

10.3823/839 ◽  
2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shinta Dewi Rasti ◽  
Maftuchah Rochmanti ◽  
Relly Yanuari Primariawan
Keyword(s):  
General Hospital ◽  
Latency Period ◽  
Good Choice ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Infant Outcomes ◽  
Preterm Premature Rupture ◽  
Group A ◽  
Group B ◽  
Infant Birth

Introduction: Antibiotics are well known and recommended as the main therapy for preterm premature rupture of membranes (PPROM.) But the research on antibiotics other than the recommended macrolides regimens is still lacking. This research aims to evaluate whether there are effects differences of cefotaxime and ceftriaxone given on pregnancy with PPROM by comparing the duration of the latency period and the infants outcomes. Material and Methods: Data was taken retrospectively through medical records at Dr. Soetomo Surabaya General Hospital, Indonesia during the period of January-December 2017. The inclusion criteria were a history of PPROM in pregnancy <37 weeks, given cefotaxime or ceftriaxone therapy, and have labor data. The analysis was performed by the Mann-Whitney comparison test for the latency period and Fisher's exact test for infant outcomes. Results: There were 52 samples obtained. The antibiotics used were cefotaxime 3x1gr (A) and ceftriaxone 2x1gr (B). The results of the analysis showed that there were no significant differences between the types of antibiotics with the length of the latency period, with a value of p = 0,601 (p>0,05), where group A had a median of 52,67 hours and group B was 34,17 hours. Group A was found to be more able to extend the latency period for >48 hours with a percentage of 57,8%, whereas in group B only 42,9%. There are no significant differences in infant outcomes; infant birth weight and Apgar score among the two therapies used. Conclusion: Cefotaxime was more preferably to be used in the Dr. Soetomo Surabaya General Hospital. Nevertheless, ceftriaxone can still be a good choice for PPROM therapy since both cephalosporins have succeeded in preventing infections in women with PPROM.

scholarly journals Pregnancy outcome in preterm premature rupture of membranes between 24 to 34 weeks of gestation

2020 ◽  
Vol 9 (12) ◽  
pp. 5043
Author(s):  
Sujatha Venkatraman ◽  
Latha Chaturvedula ◽  
Subhash Chandra Parija
Keyword(s):  
Respiratory Distress ◽  
Neonatal Intensive Care ◽  
Latency Period ◽  
Primary Objective ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Group B Streptococci ◽  
Preterm Premature Rupture ◽  
Nicu Admission ◽  
Group B

Background: Preterm premature rupture of membranes (PPROM) is spontaneous rupture of the fetal membranes before 37 completed weeks and before onset of labour which complicates 3-5% of all pregnancies. Studies regarding PPROM in very early gestation are lacking. The primary objective was to assess the maternal and perinatal outcome in preterm premature rupture of membranes and secondary objective was to assess the colonization of group B Streptococci (GBS) and Listeria monocytogenes in patients with PPROM.Methods: This prospective study was performed on 175 antenatal women with PPROM between 24 to 34 weeks of gestation.Results: Majority of women (54.2%) were between 32 to 34 weeks of gestation, 37% were between 28 to 32 weeks of gestation and 7.8% were between 24 to 28 weeks of gestation. About 22 % of women had cervicovaginal infections. The prevalence of group B Streptococci in the study group was 1.2% and no isolates of Listeria. The most common maternal morbidity was puerperal fever (11.4 %). Among newborn babies 87 (55 %) required neonatal intensive care unit (NICU) admission mainly for respiratory distress and prematurity. With each week of increase in gestational age, there is decrease in latency period by 22 hours and duration of NICU stay nearly by one day.Conclusions: From the present study it may be concluded that PPROM is associated with genitourinary infection, puerperal pyrexia and respiratory distress syndrome among neonates. The prevalence of group B Streptococci in antenatal women with PPROM is very low and no Listeria were isolated.

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