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 A Study on Management of Premature Rupture of Membranes (PROM)

2020 ◽  
Vol 32 (2) ◽  
pp. 94-98
Author(s):  
Arnab Mondal ◽  
Rupak Ranjan Roy ◽  
Asok Kumar Mondal
Keyword(s):  
Gestational Age ◽  
Labor Pain ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Medical College ◽  
One Year ◽  
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 & management of PROM has 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. Materials and methods: In this study, the definition of PROM used 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. A cohort study was conducted in the Dept. of Obs & Gynae of KPL Medical College & Hospital, Kolkata on 100 cases of PROM and 100 cases of comparison group, over a period of one year. Results: It was observed that onset of labor was more rapid with increasing gestational age, use of oxytocin for induction & augmentation of labor & operative deliveries were higher in PROM cases. Conclusion: Individualized management of PROM cases depending on the gestational age and risk of complications is the best way to achieve a good feto-maternal outcome. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 94-98

scholarly journals FAKTOR DETERMINAN PADA KETUBAN PECAH DINI

2018 ◽  
Vol 11 (1) ◽  
pp. 053-061
Author(s):  
Fitriyani Fitriyani
Keyword(s):  
Gestational Age ◽  
Maternal Age ◽  
Preterm Births ◽  
Dominant Factor ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Fetal Abnormalities ◽  
Chi Square Test

Every year the incidence of premature rupture of membranes ranges from 5-10% of all preterm preterm births and membranes occurring in 1% of all pregnancies.70% of cases of premature rupture of membranes occur in early pregnancy, prematurerupture of membranes is the cause of preterm birth as much as 30% (Manuaba, 2010). Atthe Derah Kepahiang General Hospital, the incidence of premature rupture of membranesis 219 cases in 2016.This research is analytical descriptive research with case controldesign. The sample in this study amounted to 138 people divided into two groups of 69cases and 69 controls. Statistical test using chi square test and binary logisticregression.Results of the study of 69 people with premature rupture of membranes atmaternal age <20 and> 35 years (46.4%), primiparity and grandemultipara parity(62.3%), fetal abnormalities (33.3%), gestational age aterm ( 63.8%) and those with ahistory of premature rupture (18.8%) in Kepahiang Hospital by 2016. Maternal age (pvalue0.013 OR = 2.646), parity (p-value 0.0,0 OR OR = 3.111) (p-value 0,0017 OR =2,950), gestational age (p-value 0,386) and history of premature rupture (p-value 0,167)at Kepahiang Hospital 2016. The most dominant factor causing premature rupture ofmembranes in RSUD Kepahiang year 2016 is parity (Exp (B) 2,806).It is expected thatthe hospital can use the research as input to suppress the incidence of premature ruptureof membranes, by counseling to explain the risk factors of premature rupture ofmembranes, especially maternal age, parity and fetal abnormalities.

scholarly journals A study on fetomaternal outcome in premature rupture of membranes

2018 ◽  
Vol 7 (3) ◽  
pp. 897
Author(s):  
Arnab Mondal ◽  
Sanhita Kanungo
Keyword(s):  
Gestational Age ◽  
Perinatal Death ◽  
Postnatal Period ◽  
Labor Pain ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Neonatal Complications ◽  
Increased Risk ◽  
Clinical Culture

Background: Premature rupture of membranes (PROM) is a common obstetric complication. This condition may lead to maternal complications like puerperal hemorrhage, puerperal sepsis, chorioamnionitis, maternal death etc. due to increased risk of infections and operative interventions. It may also lead to neonatal complications like prematurity, respiratory distress syndrome (RDS), sepsis, low birth weight (LBW) and perinatal death. The aim of the study was to find out whether certain maternal and neonatal complications were significantly higher in PROM cases than controls.Methods: In the present study, the definition of PROM adopted is – rupture of fetal membranes before the onset of true labor pain. The lower limit of gestational age was taken to be 28 weeks. Diagnosis of PROM was mainly clinical. Culture sensitivity test of amniotic fluid was done. The mother was observed throughout labor and postnatal period till discharge and any complications were noted. The baby was also observed from birth till discharge and any complications and interventions were noted. Data obtained was analysed by appropriate statistical methods to obtain results and reach the conclusion.Results: The results of the study showed that the incidence of puerperal hemorrhage, LBW babies, prematurity, maternal morbidities, chorioamnionitis, perinatal mortality and neonatal morbidities were significantly higher in PROM cases. These results corroborated with the findings of other researchers most of the time.Conclusions: It was concluded 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 in such cases.

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.

The Use of Somatex Shunt for Fetal Pleural Effusion: A Cohort of 8 Procedures

2021 ◽  
pp. 1-8
Author(s):  
Man Yan Chung ◽  
Wing Cheong Leung ◽  
Wing Ting Tse ◽  
Yuen Ha Ting ◽  
Kwok Ming Law ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Gestational Age ◽  
Single Case ◽  
Perinatal Outcomes ◽  
In Utero ◽  
Good Survival ◽  
Pleural Effusions ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Live Births

<b><i>Introduction:</i></b> Fetal pleural effusion may require in utero shunting which is associated with procedure-related complications. <b><i>Objective:</i></b> To evaluate the efficacy and complications of the newly designed Somatex shunt in treating fetal pleural effusion. <b><i>Methods:</i></b> Consecutive cases with primary fetal pleural effusion who were treated with the Somatex shunt between 2018 and 2019 were evaluated. Perinatal outcomes and complications were retrospectively analyzed. <b><i>Results:</i></b> There were 6 cases of unilateral and 1 case of bilateral pleural effusion, and hence a total of 8 pleuroamniotic shunting procedures were performed. The median gestational age at diagnosis and shunting was 20.7 and 22.6 weeks, respectively. All 8 procedures were successful, achieving complete in utero drainage. All but one were live births (85.7%) with a median gestational age of 38 weeks. The single case of in utero death occurred 4.7 weeks after successful shunting, and no cause could be identified after autopsy. The rates of preterm birth and premature rupture of membranes were 33.3% (2/6) and 16.7% (1/6), respectively. Four of the 8 procedures (50%) had minor shunt-related complications such as dislodgement and entrapment, occurring at a median of 7.7 weeks after shunting. None of the shunts became blocked. <b><i>Conclusions:</i></b> The Somatex shunt is effective in relieving fetal pleural effusions with good survival rate. Overall, it was a safe instrument, though minor shunt complications occurred.

scholarly journals Hubungan Ketuban Pecah dengan Kejadian Asfiksia Neonatorum di RSUD Kabupaten Kediri Tahun 2016

2017 ◽  
Vol 3 (2) ◽  
pp. 19
Author(s):  
Yanu Yufita Lestariningsih
Keyword(s):  
Public Hospital ◽  
Simple Random Sampling ◽  
Fetal Membrane ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Asphyxia Neonatorum ◽  
Chi Square Test ◽  
Almost All

Premature rupture of  membranerevolves 5-10% from all birth. Impact a birth premature that espoused broken fetal membrane early causess 12-15% asphyxia neonatorum. The purpose of the study to determine the correlation between premature rupture of  membrane with the incidence of asphyxia neonatorum. The research method used is analytic with retrospective cohort approach with independent variable of premature rupture of membrane, dependent variable asphyxia neonatorum. The study was conducted on 7 June to 12 July 2017. The population of 1519 mothers inregional public hospital of Kediri regency 2016. Sample 139 respondents, taken by simple random sampling, was analyzed by Chi Square test with a significant of 0.05. Result of research most of respondent with rupture of membrane counted 46 respondents, almost all respondents that is 82.6% gave birth baby with asphyxia. From result of Chi Square test obtained by result of p-value equal to 0.000 (<0.05), result of coefficient of contingency (C) equal to 0.639 with closeness strong relation, so H1 received H0 rejected which means there is significant relation with closeness strong between premature rupture of membrane with asphyxia neonatorum inregional public hospital of Kediri regency 2016. Relative Risk (RR) 1.65 which means the possibility of a baby experiencing asphyxia neonatorum of 1.65 times in maternal who experience premature rupture of membranes compared to mothers who did not experience premature rupture of membranes.

scholarly journals 1035325 Hubungan Kadar Hemoglobin Ibu dan Letak Janin dengan Kejadian Ketuban Pecah Dini di Klinik Alisa Talang Kramat Kenten Tahun 2018

2019 ◽  
Vol 9 (1) ◽  
pp. 26-31
Author(s):  
Desi Hariani
Keyword(s):  
Univariate Analysis ◽  
Sampling Technique ◽  
Hemoglobin Level ◽  
Survey Method ◽  
Bivariate Analysis ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Chi Square ◽  
Fetal Abnormalities

ABSTRAK Ketuban pecah dini adalah pecahnya selaput ketuban pada setiap saat sebelum permulaan persalinan tanpa memandang apakah pecahnya selaput ketuban terjadi pada kehamilan 24 minggu atau 44 minggu. Kadar hemoglobin adalah ukuran pigmen respiratorik dalam butiran-butiran darah merah. Kelainan letak janin merupakan malpresentasi janin atau kelainan letak janin yang dapat membuat ketuban bagian terendah langsung menerima tekanan intra uteri yang dominan. Tujuan penelitian ini adalah mengetahui hubungan kadar hemoglobin ibu dan letak janin dengan kejadian ketuban pecah dini di klinik alisa talang keramat kenten Palembang Tahun 2018. Desain penelitian ini menggunakan metode survey analitik dengan pendekatan crossectional. Sampel berjumlah 63 orang. Pengambilan menggunakan teknik total sampling. Pengumpulan data menggunakan lembar checklist.Hasil analisis univariat didapatkan jumlah ibu yang mengalami ketuban pecah dini (22,3%), HB tidak normal (41,3%) dan letak sungsang (6,3%).  Dari hasil analisis bivariat dengan uji statistik Chi – Square ada hubungan bermakna antara kadar hemoglobin ibu p value  = 0,001 < α 0,05 nilai OR = 0,049 dan letak janin p value = 0,001 < α 0,05 nilai OR = 0,032 dengan kejadian ketuban pecah dini secara statistik terbukti. Melalui penelitian ini, diharapkan dapat memberikan pelayanan kesehatan yang lebih baik lagi pada ibu hamil dan bersalin sehingga tidak terjadi komplikasi.   Kata Kunci : Ketuban Pecah Dini, Kadar Hemoglobin, Letak Janin ABSTRACT Premature rupture of membranes isthe  rupture of the membranes at any time before the onset of labor, regardless of whether the rupture of the membranes occurs at 24 weeks or 44 weeks' gestation. Hemoglobin levels are the size of respiratory pigments in red blood granules. Fetal abnormalities are malpresentations of fetuses or fetal abnormalities that can make the lowest part of the membrane directly accept the dominant intrauterine pressure. The aim of this study is to know the correlation between maternal hemoglobin level and fetal location toward the incidence of premature rupture of membranes at klinik alisa talang keramat kenten The study design using analytical survey method with crossectional approach. The sample numbered 63 people. Taking by using total sampling technique. Data collection using checklist sheet. The result of univariate analysis showed that the number of mothers who had membranes rupturedearly was (22.3%), HB was not normal  (41.3%) and breech position was (6.3%). From bivariate analysis with Chi-Square statistical test there was a significant correlation between maternal hemoglobin level p value = 0.001 <α 0.05 value OR = 0.049 and fetal location p value = 0.001 <α 0.05 value OR = 0.032 with incidence of premature rupture of membranes was statistically proven. Through this research, it is expected to provide better health services in pregnant and maternity women so thereis no complications occur. Key word  : Premature rupture of membranes, Hemoglobin levels, Fetal Location

scholarly journals Short Term Outcomes of Neonates Born after Prolonged Premature Rupture of Membranes < 34 Weeks Gestation

2019 ◽  
Vol 4 (2) ◽  
pp. 83
Author(s):  
Isam Bsisu ◽  
Alaa Aldalaeen ◽  
Rawan Elrajabi ◽  
Ala AlZaatreh ◽  
Rama Jadallah ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Births ◽  
University Hospital ◽  
High Rate ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Gestational Week ◽  
The Mean

<p><strong><em>Background:</em></strong><em> Preterm premature rupture of membranes (PPROM) is responsible for one?third of all preterm births worldwide. This aim of this study was to investigate the outcome of neonates born after prolonged PPROM with gestational age below 34 weeks. </em></p><p><strong><em>Materials and methods:</em></strong><em> This retrospective study included 65 patients who were born to mothers with Prolonged PPROM &lt;34 weeks gestation between January 2011 and December 2015 and admitted to the neonatal intensive care unit (NICU) at Jordan University Hospital. </em></p><p><strong><em>Results: </em></strong><em>The mean gestational age of included patients was (31.9 ± 2.5 weeks), mean birth weight was (1840 ± 583 g) and 43 (66.2%) were males. The mortality rate in those infants was 12.3 %. Gestational age, birth weight, and Apgar score were significantly lower among mortality cases compared to surviving cases (P &lt; 0.05). </em></p><p><strong><em>Conclusion:</em></strong><em> Prolonged PPROM before the 34<sup>th</sup> gestational week is associated with high rate of morbidity and mortality, for which early identification of risk factors for developing PPROM can help in reducing the risk for preterm labors and subsequent burden on healthcare system.</em></p>

scholarly journals Patterns of placental pathology in preterm premature rupture of membranes

2013 ◽  
Vol 4 (3) ◽  
pp. 249-255 ◽  
Author(s):  
J. Armstrong-Wells ◽  
M. D. Post ◽  
M. Donnelly ◽  
M. J. Manco-Johnson ◽  
B. M. Fisher ◽  
...  
Keyword(s):  
Gestational Age ◽  
Pathological Finding ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Exact Test ◽  
Preterm Premature Rupture ◽  
Chorionic Plate ◽  
Adverse Neonatal Outcomes ◽  
Insight Into

Inflammation is associated with preterm premature rupture of membranes (PPROM) and adverse neonatal outcomes. Subchorionic thrombi, with or without inflammation, may also be a significant pathological finding in PPROM. Patterns of inflammation and thrombosis may give insight into mechanisms of adverse neonatal outcomes associated with PPROM. To characterize histologic findings of placentas from pregnancies complicated by PPROM at altitude, 44 placentas were evaluated for gross and histological indicators of inflammation and thrombosis. Student's t-test (or Mann–Whitney U-test), χ2 analysis (or Fisher's exact test), mean square contingency and logistic regression were used when appropriate. The prevalence of histologic acute chorioamnionitis (HCA) was 59%. Fetal-derived inflammation (funisitis and chorionic plate vasculitis) was seen at lower frequency (30% and 45%, respectively) and not always in association with HCA. There was a trend for Hispanic women to have higher odds of funisitis (OR = 5.9; P = 0.05). Subchorionic thrombi were seen in 34% of all placentas. The odds of subchorionic thrombi without HCA was 6.3 times greater that the odds of subchorionic thrombi with HCA (P = 0.02). There was no difference in gestational age or rupture-to-delivery interval, with the presence or absence of inflammatory or thrombotic lesions. These findings suggest that PPROM is caused by or can result in fetal inflammation, placental malperfusion, or both, independent of gestational age or rupture-to-delivery interval; maternal ethnicity and altitude may contribute to these findings. Future studies focused on this constellation of PPROM placental findings, genetic polymorphisms and neonatal outcomes are needed.

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.

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