scholarly journals Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

2016 ◽  
Vol 62 (3) ◽  
pp. 269-275 ◽  
Author(s):  
Alex Sandro Rolland Souza ◽  
Adriane Farias Patriota ◽  
Gláucia Virgínia de Queiroz Lins Guerra ◽  
Brena Carvalho Pinto de Melo

SUMMARY Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

2021 ◽  
Vol 29 (1) ◽  
pp. 27-32
Author(s):  
Subhashini Ladella ◽  
David Lee ◽  
Fatemeh Abbasi ◽  
Brian Morgan

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.


Author(s):  
Malú Flôres Ferraz ◽  
Thaísa De Souza Lima ◽  
Sarah Moura Cintra ◽  
Edward Araujo Júnior ◽  
Caetano Galvão Petrini ◽  
...  

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.


2012 ◽  
Vol 34 (2) ◽  
pp. 154-158 ◽  
Author(s):  
Claudine Storness-Bliss ◽  
Amy Metcalfe ◽  
Rebecca Simrose ◽  
R. Douglas Wilson ◽  
Stephanie L. Cooper

2016 ◽  
pp. 58-64
Author(s):  
O.B. Malanchuk ◽  
◽  
V.P. Lakatosh ◽  
O.U. Kostenko ◽  
M.I. Antonuk ◽  
...  

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.


1991 ◽  
Vol 165 (4) ◽  
pp. 1088-1094 ◽  
Author(s):  
James A. Harding ◽  
David M. Jackson ◽  
David F. Lewis ◽  
Carol A. Major ◽  
Michael P. Nageotte ◽  
...  

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