A study on fetomaternal outcome in premature rupture of membranes

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.

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A study on management of premature rupture of membranes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180412 ◽

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.

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

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v32i2.48280 ◽

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

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Study of Fetomaternal Outcome in Premature Rupture of Membranes in Pregnancy More Than 34 Weeks

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3287 ◽

2020 ◽

Vol 11 (4) ◽

pp. 6136-6143

Author(s):

Amruta Choudhary ◽

Sudha Rani ◽

Gunchoo Kundi ◽

Arpita Jaiswal

Keyword(s):

Prospective Observational Study ◽

Neonatal Morbidity ◽

Tertiary Hospital ◽

Morbidity And Mortality ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Maternal Complications ◽

Exclusion Criteria ◽

Neonatal Complications ◽

Timely Referral

Premature rupture of membranes (PROM) affects approximately 10% of pregnant women. PROM, when unattended or mismanaged may lead to severe maternal and neonatal complications. The present study aims to study the subsequent course of pregnancy and evaluate the maternal, and neonatal morbidity and mortality in PROM patients admitted in our hospital. To study the outcome of PROM and assess the maternal and perinatal morbidity and mortality. It was a prospective observational study. All the patients of PROM admitted in hospital and considered based on inclusion and exclusion criteria were included in the study. They were induced with either oxytocin or misoprostol depending on their Bishops score. In the group of patients, where PROM delivery interval >18 hours were found to have more maternal complications like puerperal sepsis, chorioamnionitis, wound gape, paralytic ileus, and more neonatal complications like jaundice, sepsis. In our study, maternal morbidity was directly related to the PROM delivery interval. Thus, women diagnosed with PROM should be hospitalised early or referred early to tertiary hospital and actively managed and followed up till delivery. Timely referral and timely intervention can further improve perinatal outcome.

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Risk of Expectant Management and Optimal Timing of Delivery in Low-Risk Term Pregnancies: A Population-Based Study

American Journal of Perinatology ◽

10.1055/s-0037-1607042 ◽

2017 ◽

Vol 35 (03) ◽

pp. 262-270 ◽

Cited By ~ 1

Author(s):

Sarah Nazeer ◽

Komal Kumar ◽

Morgan Warren ◽

Jing Dai ◽

Robert Sokol ◽

...

Keyword(s):

Gestational Age ◽

Expectant Management ◽

Population Based ◽

Optimal Timing ◽

Maternal Complications ◽

Population Based Study ◽

Neonatal Complications ◽

Early Term ◽

Management Group ◽

Increased Risk

Objective The benefits of the 39-week rule have been questioned and concerns of increased stillbirth after adoption of this rule have been raised. Whether expectant management risks outweigh the benefits of awaiting 39 weeks has not been studied. We analyze the risks of expectant management at term and the optimal timing for delivery. Study Design All U.S. nonanomalous singleton term deliveries in 2013 were selected, excluding diabetes/hypertension, and low birth weight. Maternal/neonatal complications and stillbirth/infant death were compared among expectant management versus deliveries at each term gestational age. Logistic regression was used to calculate adjust odds ratios of complications according to delivery plan at each gestational age. Results From approximately 3 million deliveries, maternal complications during expectant management were lower at early term, and became higher at 39 weeks, relative risk [RR] (95% confidence interval [CI]) = 1.18 (1.16–1.19). Neonatal complications during expectant management were lower during early term, and became higher at ≥39 weeks, RR (95% CI) = 1.09 (1.08–1.09). The risk of perinatal mortality in the expectant management group was lower during early term, and became higher at ≥39 weeks, 18.93 (17.83–20.10) versus 17.37 (16.61–18.16), p = 0.010. Conclusion Complications during expectant management occurring while awaiting full term do not outweigh the benefits of better outcomes from reaching 39 weeks. However, extending beyond 39 weeks may put these pregnancies at an increased risk.

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

Fetal Diagnosis and Therapy ◽

10.1159/000515849 ◽

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

Introduction: Fetal pleural effusion may require in utero shunting which is associated with procedure-related complications. Objective: To evaluate the efficacy and complications of the newly designed Somatex shunt in treating fetal pleural effusion. Methods: 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. Results: 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. Conclusions: 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.

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Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

Journal of Clinical Medicine ◽

10.3390/jcm10040643 ◽

2021 ◽

Vol 10 (4) ◽

pp. 643

Author(s):

Veronica Giorgione ◽

Corey Briffa ◽

Carolina Di Fabrizio ◽

Rohan Bhate ◽

Asma Khalil

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Chi Square ◽

Increased Risk ◽

Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

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Epidemiological characteristics of neonatal admissions in a public maternity / Características epidemiológicas das internações neonatais em uma maternidade pública / Características epidemiológicas de admisión neonatal en una maternidad..

Revista de Enfermagem da UFPI ◽

10.26694/2238-7234.6428-32 ◽

2018 ◽

Vol 6 (4) ◽

pp. 28

Author(s):

Danubia Jacomo Da Silva Cardoso ◽

Beatriz Schumacher

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Medical Records ◽

Preterm Labor ◽

Neonatal Intensive Care ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Maternal Complications ◽

Epidemiological Characteristics

Descriptive retrospective Research with quantitative approach. Aims: Meet the epidemiological characteristics of hospitalization in Neonatal intensive care unit, relating them to the possible maternal factors, in a public maternity in southern Brazil. Performed with newborns that they put in the NICU, forwarded with the clinical summary to the Municipal program precious baby. The data were collected, with the following variables: maternal age, type of birth, number of pre-natal consultations, complications in pregnancy, and number of days of hospitalization in neonatal intensive care unit, in the period from January to December 2013. Were analyzed medical records 72, prematurity was the most prevalent with 61% of the babies, and their consequences such as the use of mechanical ventilation and apneas 55.5% were repeated and 52.7% respectively. Among the most frequent maternal complications was observed the Preterm Labor (31.3%) and premature rupture of membranes (23.8%). Thus the identification of the factors that lead to preterm labor and premature rupture of membranes, could meet the maternal background and consequently reduce the prematurity and low birth weight.

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Pregnancy Outcome of Twin Pregnancy at Gandaki Medical College Teaching Hospital, Pokhara, Nepal

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v11i02.22898 ◽

2018 ◽

Vol 11 (02) ◽

pp. 1-4

Author(s):

M Tripathi ◽

R Shrestha

Keyword(s):

Preterm Delivery ◽

Teaching Hospital ◽

Gestational Age ◽

Twin Pregnancy ◽

College Teaching ◽

Neonatal Morbidity ◽

Maternal Complications ◽

Cross Sectional ◽

Neonatal Complications ◽

Twin Pregnancies

Objectives: To evaluate maternal and neonatal complications and pregnancy outcomes of twin pregnancies. Methods: The cross sectional study was conducted using retrospective data on the twin pregnancies with more than 28 weeks of gestational age. The study used data over a period of five years, from March 10, 2010 to March 9, 2015 in the Department of Obstetrics and Gynecology, GMC Teaching Hospital Pokhara. Results: Of the 50 twin pregnancies, the most common maternal complication was preterm delivery (40%). Other maternal complications were anemia (36%), pregnancy induced hypertension (14%), premature rupture of membranes (14%), postpartum hemorrhage (12%) and antepartum hemorrhage (6%). Median gestational age at delivery was 37 weeks. Most common route of delivery was cesarean section (66%). Most common neonatal complication was low birth weight (48%) births first twin and second twin 56%. Conclusion: Twin pregnancy has high maternal and neonatal complications, especially preterm delivery that increases the risk of significant neonatal morbidity and mortality.

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Outcome of Twin Pregnancy in a Periurban Hospital

Bangladesh Journal of Obstetrics & Gynaecology ◽

10.3329/bjog.v27i2.29919 ◽

2016 ◽

Vol 27 (2) ◽

pp. 57-62

Author(s):

Saria Tasnim ◽

FM Anamul Haque ◽

Sameena Chowdhury

Keyword(s):

Birth Weight ◽

Twin Pregnancy ◽

Perinatal Death ◽

Post Partum ◽

Mode Of Delivery ◽

Labor Pain ◽

Maternal Complications ◽

Management Options ◽

History Of ◽

Second Twin

Objective: To determine the socio demographic characteristics, clinical presentation and obstetric outcome at delivery and immediate postpartum period of twin gestation in a periurban hospitalMaterial & Methods: An observational study was conducted between January 2000 to December 2004 at Institute of Child and Mother Health. All twin pregnancy irrespective of gestational age admitted in the in-patient department of Institute of Child and Mother Health for delivery and also those undiagnosed cases found to have twin birth were enrolled in the study consecutively from January 2001 to December 2004. Data on socio-demographic factors, predisposing factors for twin gestation and obstetric characteristics was collected using a structured questionnaire. Hospital records were consulted for recording the investigation reports and management options. The outcome variables were maternal complications during antenatal, intranatal and immediate postnatal period, mode of delivery, birth weight and sex of newborn and fetal outcome. All twin pregnancies from the admitted obstetric patients were enrolled consecutivelyResults: During the study period there were 11,185 deliveries and among them 107 were twin gestation. About 22% were primigravida, 78.5% multigravida, 27.1% were illiterate. Most common age group were 24-29 years (39.4%). Antenatal care was availed by 71% of patients and 27.1% twins were not diagnosed till delivery. Family history of twin on maternal side was present in 58.1% and 31.8% had history of taking oral contraceptive immediately before the pregnancy. Ovulation inducing agents were given to 8.3% of twin. Presentations of fetus were both vertex 54.2%, 1st vertex and second breech 16%, and both breech 5.7%. About 55.1% were admitted with labor pain, 6.5% were undelivered second twin. Preterm birth was 27.2% and low birth weight of 1st baby 79.6% and second baby 80.9% respectively. Mode of delivery was vaginal delivery of both fetus 41.6%, caesarean section of both fetus 62.4%, and caesarean for second twin 3.1%. Same sex of both twins was found in 78% and male-male pair was 50%. There was one stillbirth, one conjoined twin and perinatal death was 11.2% Complications encountered during perinatal period were severe abdominal pain 9.3%, retained placenta in 7.3%; and post partum hemorrhage in 4.6% cases.Conclusion: Twin pregnancy is quite common and warrants specialized care during ante partum, intrapartum and postpartum period.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 57-62

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

Research in Health Science ◽

10.22158/rhs.v4n2p83 ◽

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

Background: 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. Materials and methods: This retrospective study included 65 patients who were born to mothers with Prolonged PPROM <34 weeks gestation between January 2011 and December 2015 and admitted to the neonatal intensive care unit (NICU) at Jordan University Hospital. Results: 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 < 0.05). Conclusion: Prolonged PPROM before the 34th 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.

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