scholarly journals Analysis of the factors affecting the duration of the latent period from the moment of prelabor rupture of membranes to the onset of labor

2020 ◽  
Vol 20 (5-6) ◽  
pp. 15-24
Author(s):  
Maria A. Kaganova ◽  
Natalya V. Spiridonova
Keyword(s):  
Amniotic Fluid ◽  
Latent Period ◽  
Gestational Age ◽  
Latency Period ◽  
Full Term ◽  
Premature Rupture Of Membranes ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Latency Interval ◽  
The Moment

Introduction. Premature rupture of membranes during full-term pregnancy represents an increased risk of septic complications for both the mother and the fetus due to the prolongation of the latency period, the period from the discharge of amniotic fluid till the onset of labor. Purpose of the study: to assess the factors affecting the duration of the latent period (from the moment of discharge of amniotic fluid to the development of labor) during full-term pregnancy. Materials and methods. A prospective analysis of the labor of 136 patients with premature rupture of membranes and full-term pregnancy (37-42 weeks) of low and moderate risk groups, without contraindications for vaginal birth was carried out. Patients with Bishops cervical score less than or equal to 7 points made up the main group (70 pregnant women). Patients with mature cervix were included in the comparison group (66 cases). The analysis of the duration of the latent period was carried out with the use of correlation and regression analysis. Results. The time from the moment of discharge of amniotic fluid to the onset of regular labor in the group with a cervix 7 Bishop points was 7.82 4.53 hours, while in the group with a cervix 8 Bishop points it was 4.4 3.23 hours (T = 5.02; p 0.001). The most significant effect on the duration of the latency period was the assessment of the cervix according to Bishop scale (r = 0.48; p 0.001), the gestational age was in the second place (r = 0.23; p = 0.08). In patients who didnt take mifepristone, the main factors influencing the duration of the latency interval were fetal weight (r = 0.31; p = 0.004) and gestational age (r = 0.29; p = 0.008); the increase in these parameters led to the decrease in the latency interval. Women who received 200 mg mifepristone in labour had a significant positive correlation with maternal age (r = 0.36; p = 0.04), negative with maternal weight (r = 0.42; p = 0.01) and cervical Bishop score (r = 0.48; p = 0.004). Women in labor with the longest latency interval, who received mifepristone in a daily dosage of 400 mg, have an inverse correlation for the gestational age (r = 0.39; p = 0.09), connection with the degree of cervical maturity, age, constitutional features, gestational age was not revealed. Conclusion. The main predictors of the duration of the latency period of premature rupture of membranes at full-term pregnancy were the degree of cervical maturity according to Bishop scale, gestational age and fetal weight at birth.

scholarly journals The role of latency period on the preterm premature rupture of membranes: implication for treatment

2021 ◽  
Author(s):  
Lin Lu ◽  
Jianhua Li ◽  
Bei Gan ◽  
Shan Zheng ◽  
Lihong Chen
Keyword(s):  
Logistic Regression ◽  
Amniotic Fluid ◽  
Influencing Factors ◽  
Gestational Age ◽  
Latency Period ◽  
Regression Analyses ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Amniotic Fluid Volume

IntroductionConservative treatments with latency period have been used for the treatment of preterm premature rupture of membranes (PPROM) in clinical practice, we aimed to evaluate the role and potential influencing factors of latency period, to provide insights to the clinical treatment of PPROM.Material and methodsPPROM pregnant women treated in our hospital from January 1, 2015 to September 30, 2020 were included. PPROM patients were divided into 48～168h group and the >168h latency group, the characteristics and prognosis of this two groups were compared and analyzed. Logistic regression analyses were conducted to analyze the relevant influencing factors of latency period.ResultsA total of 131 PPROM patients were included. There were significant differences on the age, BMI, gestational age on admission, amniotic fluid volume before childbirth, and positive rate of cervical secretion culture between two groups (all p<0.05). Logistic regression analyses indicated that the latency period was shorter in the PPROM patients with age≥30y(OR0.048, 95%CI0.121~0.863) and gestational age≥32w on admission(OR0.463, 95%CI0.069~0.811), and the latency period was prolonged in the PPROM patients with BMI≥23kg/㎡(OR1.591, 95%CI1.134~1.944) and amniotic fluid volume≥6cm(OR2.129, 95%CI1.093~3.042) (all p<0.05). There were significant differences in the incidence of low birth weight and NRDS between 48~168h group and >168h group (all p<0.05).ConclusionsLatency period plays an important role in the PPROM, which is associated with the pregnant women's age, BMI, gestational week of rupture and amniotic fluid index.

scholarly journals A study on management of premature rupture of membranes

2018 ◽  
Vol 7 (3) ◽  
pp. 855
Author(s):  
Arnab Mondal ◽  
Sanhita Kanoongo
Keyword(s):  
Latent Period ◽  
Gestational Age ◽  
Labor Pain ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Definition Of ◽  
Individualized Management ◽  
Optimum Management ◽  
First Stage Of Labor

Background: Premature rupture of membranes (PROM) is a common obstetric complication. Knowledge of etiopathogenesis, diagnosis, complications and management of PROM has significantly increased due to extensive research in the recent past. Yet, there is no unanimous opinion regarding optimum management of PROM. The aim of the study was to observe the patients during labor and compare the latent period, duration of first stage of labor, modes of deliveries and the use of oxytocin and its outcome in PROM cases with controls. The study has been conducted with the belief that these data will help in better management of PROM cases in future.Methods: In this study, the definition of PROM adopted is rupture of fetal membranes before the onset of true labor pain. The minimum gestational age was taken to be 28 weeks. Diagnosis of PROM was mainly clinical. Patients were monitored during the latent period and during labor. Induction of labor was done where necessary. Collected data were analysed using Chi Square Test.Results: It was observed that onset of labor was more rapid with increasing gestational age. Use of oxytocin for induction and augmentation of labor and operative deliveries were higher in PROM cases. These results mostly corroborated with the findings of other researchers.Conclusions: The conclusion drawn at the end of the study was that individualized management of PROM cases depending on the gestational age and risk of complications is the best way to achieve a good fetomaternal outcome.

scholarly journals MODERN CONDITION OF THE PROBLEM OF THE PREMATURE RUPTURE OF MEMBRANES DURING FULL-TERM PREGNANCY (REVIEW OF LITERATURE)

2017 ◽  
Vol 4 (4) ◽  
pp. 187-193
Author(s):  
V. V Astafev ◽  
S. V Nazarova ◽  
A. D Li ◽  
N. M Podzolkova
Keyword(s):  
Cost Effectiveness ◽  
Future Generation ◽  
Optimal Choice ◽  
Full Term ◽  
Review Of Literature ◽  
Premature Rupture Of Membranes ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Clinical Recommendations ◽  
Modern Condition

Premature rupture of membranes (PRM) during full-term pregnancy is a common obstetric complication. Childbirths on the background of PRM are accompanied by an increase in the frequency of the operative deliveries, as well as various obstetric complications. However, for all the diversity of tactics, techniques, clinical recommendations devoted to actions of a doctor in the management of PRM patients, the question of their choice depends on many factors. For more than 20 years of studying the PRM problem, a technique for preparing the cervix, providing 100% result has not been developed. With all the variety of choice of methods, none of them is devoid of shortcomings (contraindications to the use, cost-effectiveness, compliance of the patient, etc.). In this regard, the optimal choice of the tactics of labor in PRM cases is the insurance of the preservation of the health of the future generation.

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 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
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Amniotic Fluid Index ◽  
Apgar Scores ◽  
Preterm Premature Rupture

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.

scholarly journals A study to find out the association between duration of preterm premature rupture of the membrane’s delivery interval and maternofetal complications

2020 ◽  
Vol 10 (1) ◽  
pp. 112
Author(s):  
Anusree Saraswathy ◽  
Ajitha Ravindran ◽  
Jayshree V. Vaman ◽  
Mayadevi Brahmanandan
Keyword(s):  
Latent Period ◽  
Gestational Age ◽  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Latency Period ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Neonatal Deaths ◽  
Membrane Rupture ◽  
Preterm Premature Rupture

Background: The main maternal complications of preterm premature rupture of the membranes (PPROM) are chorioamnionitis, puerperal pyrexia, abruption and the neonatal complications are neonatal sepsis, congenital pneumonia, neonatal ICU stay and neonatal death. The aim of the study is to find out the association between duration of latent period in PPROM i.e. the time period between rupture of membrane to delivery and maternofetal complications.Methods: The present study was a Prospective observational study conducted on 240 preterm antenatal women with PPROM in the Department Obstetrics and Gynecology, SATH, GMC, Thiruvananthapuram. The gestational age at rupture of membranes, latent period from time rupture of membranes to delivery, gestational age at time of delivery and the maternal and neonatal outcome were compared and subjected to statistical analysis.Results: Maternal chorioamnionitis in the group with PPROM delivery interval between 2-7 days (79.3%) whereas there were (13.8%) in which PPROM delivery interval was less than 24 hrs. Puerperal pyrexia in 2-7 days delivery interval was 11.3% and in <24 hrs were 2.6%. Neonatal sepsis in 2-7 days was 28.3% and 12.5% in<24 hrs. Congenital pneumonia in 2-7 days was 16.9% and in<24 hrs was 11.6%.Conclusions: In the present study membrane rupture between 28-34 weeks gest age and latency period. 2-7 days were associated with high incidence of maternal chorioamnionitis, puerperal pyrexia congenital pneumonia, early onset neonatal sepsis and neonatal death. Undue prolongation of pregnancy may increase the risk of chorioamnionitis, neonatal sepsis and neonatal deaths.

scholarly journals Difference of Serum MMP9 and TNF 􀁃 Level in Preterm and Term Premature Rupture of Membranes

2016 ◽  
Author(s):  
Aji P Wibowo ◽  
Sri Sulistyowati ◽  
Supriyadi H Respati
Keyword(s):  
Gestational Age ◽  
Serum Levels ◽  
Premature Rupture Of Membranes ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Cross Sectional ◽  
The Difference ◽  
Average Serum ◽  
Metalloproteinase 9 ◽  
Necrosis Factor

Objective: To examine the difference between matrix metalloproteinase‐ 9 (MMP‐9) and Tumor Necrosis Factor 􀁃 (TNF‐􀁃) serum levels in preterm and term premature rupture of membranes (PROM). Method: Our study employed an observational cross sectional approach. Seventy samples were divided into two groups, 35 samples with preterm PROM (28‐36 weeks gestational age) and 35 samples with PROM at term pregnancy (37‐42 weeks gestational age). Both groups underwent examination for serum MMP‐9 and TNF‐􀁃 concentration using ELISA method. Statistical analysis was done using ttest. Result: Serum levels of MMP‐9 in the preterm PROM group was 2860.68K627.32 ng/ml, which was significantly higher than in the PROM at term pregnancy group 2549.74K657.15 ng/ml (p=0.04). Likewise, the average serum level of TNF‐􀁃 in subjects with preterm PROM was 12,086.60K5384.51 ng/ml, significantly higher in comparison to PROM at term pregnancy, which was 6422.51K2645.32 ng/ml (p=0.00). Conclusion: Serum levels of MMP‐9 and TNF‐􀁃 in preterm PROM is significantly higher than that in PROM at term pregnancy. Keywords: MMP‐9, premature rupture of membranes, preterm, term, TNF‐􀁃

scholarly journals Features of labor induction with patients with the premature rupture of membranes associated with the lack of biological readiness for deliveri in case of full-term pregnancy

2016 ◽  
Vol 65 (1) ◽  
pp. 4-8 ◽  
Author(s):  
Vyacheslav M Bolotskih ◽  
Marina H Afanasieva ◽  
Tatiana U Kuzminykh
Keyword(s):  
Comparative Analysis ◽  
Labor Induction ◽  
Full Term ◽  
Premature Rupture Of Membranes ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Term Delivery

The comparative analysis of outcomes of term delivery has been performed in this paper depending on the approach to labor induction affected by the premature rupture of membranes (PROM). A significant improvement in obstetric indicators has been revealed in case of prescription of Mifepristone 6 hours before the labor induction. The deterioration of obstetric indicators with patients with PROM when inducing labor in connection with the lack of biological readiness for delivery has been shown.

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