scholarly journals Bacterial vaginosis as a risk factor of preterm premature rupture of membrane (PPROM)

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Aanak Agung Gde Putra Wiraguna ◽  
Luh Made Mas Rusyati ◽  
I Dewa Ayu Vanessa Vijayamurthy
Keyword(s):  
Risk Factor ◽  
Bacterial Vaginosis ◽  
Control Method ◽  
Fibrous Tissue ◽  
Normal Pregnancy ◽  
Average Score ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Risk Of Rupture

Introduction: The pathogenesis of PPROM is complex and not fully understood. Recent studies showed that such role of genital tract infection as bacterial vaginosis in the pathogenesis of PPROM turned out to be present. They produce lipase enzymes in which they can form compounds with the fibrous tissue of amniotic membrane resulting in increased risk of rupture of the membrane.Objective This study aims to prove that bacterial vaginosis is a risk factor for preterm premature rupture of membrane.Material and methods: This research used case control method. Sampling was using the consecutive sampling method and had fulfilled inclusion and exclusion criteria with age-based matching, then vaginal swab sampling was conducted, painted with gram staining in the Dermalotogy and Venereology Laboratory of Sanglah Hospital, and Nugent score.Result: Total of 76 pregnant women with 24-36 weeks of gestation were investigated, 38 mothers with PPROM and 38 mothers with normal pregnancy. Average score of Nugent at preterm PROM was 7.18 and in normal pregnancy was 2.37. Bacterial vaginosis risking for PPROM 7 times (OR= 7.0, 95% CI= 1.21-17.68, p= 0.001).Conclusion: Bacterial vaginosis as a risk factor for the occurrence of PPROM.

scholarly journals Sildenafil versus Nifedipine Treatment of PRETERM LABOR: RCT

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Alkady ◽  
M H Mostafa ◽  
R K Elkattan
Keyword(s):  
Preterm Labor ◽  
Normal Pregnancy ◽  
The United States ◽  
Labor Pain ◽  
University Hospital ◽  
P Value ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Future Therapy

Abstract Background a normal pregnancy lasts 37 to 42 weeks, counting from the first day of the last menstrual period. A pregnancy that continues beyond 37 weeks is called a “term” pregnancy. Preterm labor is defined as labor that begins before 37 weeks of pregnancy. Approximately 12 percent of babies in the United States are born preterm; 80 percent of these are due to preterm labor that occurs on its own or after preterm premature rupture of the fetal membranes (or “broken bag of waters”). The remaining 20 percent are planned early deliveries that are done for maternal or fetal problems that prevent the woman from being able to safely continue with her pregnancy. Aim of the Work to assess the efficacy of sildenafil for stopping the labor for 48 hrs compared to nifedipine in women with preterm labor. Patients and Methods this prospective study was carried on pregnant women with preterm labor pain at Ain Shams University Hospital from March 2018 till September 2018. Study includes 88 patients which were distributed into two groups: Group S: received Sildenafil to stop preterm labor.Group N: received Nifedipine to stop preterm labor. Results in the present study we found that mean age in group receiving sildenafil (group S) was 26.55 years and in group receiving nifidpine (group N) was 26.75 years with insignificant differences between two groups as regard age p-value 0.798, also as regard. BMI and parity there was insignificant differences between two groups as regard BMI p-value 0.727, 0.815 respectively, Mean Gestational age at admission was 27.1 weeks in group S and in group N was 28.16 with insignificant differences between two groups p-value 0.705. Conclusion administration of Sildenafil in women with preterm labor pain seems to be a promising future therapy of preterm labor with, limiting the teratogenic influence of the drugs on the fetus.

The Association between Shirodkar Cerclage and Preterm Premature Rupture of Membranes in Singleton Pregnancies

2020 ◽  
Author(s):  
Alberto Muniz Rodriguez ◽  
Andrew Pastor ◽  
Nathan S. Fox
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Uterine Anomalies ◽  
Underlying Risk ◽  
Singleton Pregnancies

Objective The aim of this study was to estimate if preterm premature rupture of membranes in women with cerclage is due to the cerclage itself or rather the underlying risk factors for preterm birth in this population. Study Design This was a retrospective cohort study of singleton pregnancies who underwent Shirodkar cerclage by a single maternal–fetal medicine practice between 2005 and 2019. The control group was an equal number of randomly selected women with a singleton gestation who had a prior preterm birth and were treated with 17-OH-progesterone but no cerclage. Patients with major uterine anomalies or fetal anomalies were excluded. The primary outcome was preterm premature rupture of membranes prior to 34 weeks. Chi-square and logistic regression were used. Results A total of 350 women with cerclage (154 [44%] history-indicated, 137 [39%] ultrasound-indicated, and 59 [17%] exam-indicated) and 350 controls were included. Preterm premature rupture of membranes prior to 34 weeks did not differ between the groups (8.9% in cerclage vs. 6.0% in controls, p = 0.149, adjusted odds ratio 0.62, 95% confidence interval: 0.24–1.64) nor between the different cerclage indications (9.1% of history-indicated, 7.3% of ultrasound-indicated, and 11.9% of exam-indicated, p = 0.582). This study had 80% power with an α error of 0.05 to detect an increase in preterm premature rupture of membranes prior to 34 weeks from 6.0% in the control group to 12.0% in the cerclage group. Conclusion Cerclage does not increase the risk of preterm premature rupture of membranes prior to 34 weeks compared with other women at increased risk of preterm birth. The observed association between cerclage and preterm premature rupture of membranes is likely due to underlying risk factors and not the cerclage itself. The risk of preterm premature rupture of membranes prior to 34 weeks in women with cerclage is 10% or less and does not appear to differ based on cerclage indication. Key Points

scholarly journals Management of Gestation with Abnormal Invasive Placenta Complicated by an Extra-preterm Premature Rupture of Membranes in a Tertiary Perinatal Centre

2020 ◽  
Vol 27 (3) ◽  
pp. 113-124
Author(s):  
N. V. Mingaleva ◽  
T. B. Makukhina ◽  
E. S. Lebedenko ◽  
T. A. Anikina ◽  
M. D. Kotleva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Loss ◽  
Multidisciplinary Approach ◽  
Second Phase ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Invasive Placenta

Aim. Assessment of methods for prolonging gestation after an extra-preterm premature rupture of membranes (PROM) in a patient with abnormal invasive placenta and the efficacy of a multidisciplinary approach for treatment of a combined obstetric pathology in a tertiary perinatal centre.Results. A clinical case is reported of PROM at 22+6 weeks’ gestation in a patient with two caesarean scars on the uterus and abnormal invasive placenta. In a tertiary perinatal centre, pregnancy was prolonged to 36+3 weeks’ term. The period between PROM and delivery was 96 days. A planned caesarean section and metroplasty were performed in the setting of temporary balloon occlusion of common iliac arteries. Blood loss was 75 mL/kg. Placenta increta without chorioamnionitis was confirmed histologically. The patient stayed in the intensive care unit for two days and was discharged home on the 8th day. The newborn was assigned the Apgar score of 6/6. For two days, ventilatory support was rendered in a neonatal intensive care unit. The newborn was diagnosed with congenital pneumonia, the first-degree hypoxic-ischemic damage of the central nervous system and transferred to the second phase of nursing.Conclusions. A multidisciplinary approach and high technology facilities in the setting of a tertiary perinatal centre allow to reduce perinatal losses and provide high-quality care to patients with an increased risk of massive blood loss with the capacity to manage organ-preserving operative delivery with full rehabilitation in the postoperative period.

Complement activation fragments in cervicovaginal fluid are associated with intra-amniotic infection/inflammation and spontaneous preterm birth in women with preterm premature rupture of membranes

2021 ◽  
Author(s):  
Subeen Hong ◽  
Se Jin Lee ◽  
Yu Mi Kim ◽  
Young Eun Lee ◽  
Yehyon Park ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Complement Activation ◽  
Multivariate Analyses ◽  
Premature Rupture Of Membranes ◽  
Spontaneous Preterm Birth ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Baseline Covariates ◽  
Cervicovaginal Fluid

Objective: We sought to determine whether the levels of complement and other inflammatory and angiogenic mediators in cervicovaginal fluid (CVF) are independently associated with intra-amniotic infection and/or inflammation (IAI) and imminent spontaneous preterm birth (SPTB, ≤48 hours of sampling) in women with preterm premature rupture of membranes (PPROM). Study design: This was a retrospective study consisting of 85 singleton pregnant women with PPROM at 20+0 to 33+6 weeks. Amniotic fluid (AF) obtained via amniocentesis was cultured and assayed for interleukin-6. CVF samples collected at the time of amniocentesis were assayed for complement C3a, C4a, and C5a, HSP70, M-CSF, M-CSF-R, S100 A8, S100 A9, thrombospondin-2, VEGF, and VEGFR-1 by ELISA. Results: Multivariate logistic regression analyses revealed that elevated CVF concentrations of complement C3a, 4a and 5a were significantly associated with an increased risk of IAI and imminent SPTB, whereas those of M-CSF were associated with IAI, but not imminent SPTB (P=0.063), after adjustment for baseline covariates (e.g., gestational age at sampling). However, univariate and multivariate analyses showed that the CVF concentrations of angiogenic (thrombospondin-2, VEGF, and VEGFR-1) and inflammatory (HSP70, M-CSF-R, S100 A8, and S100 A9) proteins were not associated with either IAI or imminent SPTB. Conclusions: In women with PPROM, elevated CVF concentrations of complement C3a, C4a, and C5a are independently related to an increased risk of IAI and imminent SPTB. These findings suggest that complement activation in CVF is significantly involved in mechanisms underlying preterm birth and in the host response to IAI in the context of PPROM.

367: Uterine synechiae are associated with an increased risk of preterm premature rupture of membranes and abruption

2012 ◽  
Vol 206 (1) ◽  
pp. S172
Author(s):  
Methodius Tuuli ◽  
Anthony Shanks ◽  
Lisa Bernhard ◽  
Anthony Odibo ◽  
George Macones ◽  
...  
Keyword(s):  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk

scholarly journals Ultrasonographic evaluation of cervical length and amniotic fluid index as predictor of pregnancy outcome in case of preterm premature rupture of membrane

2018 ◽  
Vol 7 (4) ◽  
pp. 1411 ◽  
Author(s):  
Prashant Patil ◽  
Archana Kumari ◽  
H. P. Anand
Keyword(s):  
Amniotic Fluid ◽  
Pregnancy Outcome ◽  
Latency Period ◽  
Cervical Length ◽  
P Value ◽  
Premature Rupture ◽  
Amniotic Fluid Index ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Period Of Gestation

Background: Preterm premature rupture of membrane (PPROM) is among the most important cause of the perinatal morbidity and mortality. We sought to determine whether cervical length and amniotic fluid index individually or in combination can predict the pregnancy outcome in cases of PPROM.Methods: The prospective observational study was done on 170 women complicated by PPROM with gestational age between 24-36+6 weeks. They were categorized into three groups Group I.24-28 weeks, Group II.28+1 to 32 weeks and Group III. 32+1 to 36+6 weeks. Cervical length and amniotic fluid index were measured using trans abdominal ultrasound within 24 hr of admission. Maternal outcomes were recorded in terms of latency period, chorioamnionitis, and abruption , and neonatal outcomes were recorded in terms of birth weight, first minute APGAR score <7, NICU admission and early neonatal death. Qualitative variables were correlated using Chi-Square test /Fisher’s exact test. Univariate logistic regression was used to assess cervical length and AFI as a predictor of complication. A p value of <0.05 was considered statistically significant.Results: Out of 170, majority (95) belonged to 28+1 to 32 weeks group. Latency was inversely related to period of gestation (p<0.0001). A long cervical length correlated with increased latency, increased risk of chorioamnionitis and increased neonatal complications in all three groups. Also, women with PPROM having AFI >5 cm had a greater mean latency period (8.32±1.25 days) which increased their risk of developing chorioamnionitis as compared to women with PPROM having AFI ≤5 cm, who had a shorter mean latency period (7.63±1.07 days) and a lower risk of developing chorioamnionitis (p value <0.0001).Conclusions: Latency is inversely related to period of gestation. A long cervical length and increased amount of AFI correlates with increased latency, increased risk of chorioamnionitis and increased neonatal complications.

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