Effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes

Background: The aim is to study the effect of antibiotics on inflammatory marker (IL-6) and perinatal outcomes in women with preterm premature rupture of membranes (PPROM).Methods: 60 women with PPROM at 28–34 weeks of gestation were enrolled in the study. All the women were given antibiotics as per hospital protocol and were subjected to blood sampling for Interleukin -6(IL-6) at admission, delivery and umbilical cord blood. IL-6 levels were assessed for associations with adverse perinatal outcomes and the effect of antibiotic treatment on IL-6 and perinatal outcomes were studied. The data were analyzed using t test and χ2 test.Results: Increased level of IL-6 was associated with chorioamnionitis and neonatal sepsis (p<0.001). High level of IL-6 led to early delivery and complete course of antibiotics suppressed IL-6 (p<0.001) and clinical chorioamnionitis in women with PROM. Full course of antibiotics also decreased the admission rate of babies to neonatal intensive care unit and suppressed respiratory distress syndrome, neonatal sepsis.Conclusions: Increased level of IL-6 is seen in women with chorioamnionitis and neonatal sepsis. Antibiotics suppress the IL-6 levels, chorioamnionitis and neonatal sepsis.

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Perinatal Outcomes of Twin Pregnancies With Preterm Premature Rupture of the Membranes at 24–34 Weeks’ Gestation

10.21203/rs.3.rs-669989/v1 ◽

2021 ◽

Author(s):

Shuwei Zhou ◽

Yajun Yang ◽

XiaoYan Zhang ◽

Xiaoling Mu ◽

Quan Quan ◽

...

Keyword(s):

Neonatal Death ◽

Latency Period ◽

Perinatal Outcomes ◽

Neonatal Morbidity ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Factors Associated ◽

Preterm Premature Rupture ◽

Adverse Perinatal Outcomes ◽

Twin Pregnancies

Abstract Objective: To describe the perinatal outcomes of twin pregnancies with preterm premature rupture of membranes (PPROM) before 34 weeks’ gestation and identify factors associated with discharge without severe or moderate-severe neonatal morbidity.Methods: This study was conducted as a retrospective analysis of twin pregnancies with PPROM occurring at 24 0/7 to 33 6/7 weeks’ gestation. Perinatal outcomes were assessed by gestational age (GA) at PPROM. Factors associated with discharge without severe or moderate-severe neonatal morbidity were identified using logistic regression analysis.Results: Of the 180 pregnancies (360 foetuses), only 17 (9.4%) women remained pregnant 7 days after PPROM. There were 10 (2.8%) cases of prenatal or neonatal death; 303 (84.2%) and 177 (49.2%) neonates were discharged without severe or moderate-severe morbidity, respectively. As GA at PPROM increased, the adverse obstetric and neonatal outcomes decreased, especially after 32 weeks. The GA at PPROM and latency period were both significantly associated with discharge without severe or moderate-severe neonatal morbidity. Pregnancy complications and 5-min Apgar score < 7 increased severe neonatal morbidity.Conclusion: As GA at PPROM increased, the risk of adverse perinatal outcomes decreased. GA at PPROM and latency period were significantly associated with discharge without severe or moderate-severe neonatal morbidity.

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Active Versus Expectant Management for Preterm Premature Rupture of Membranes at 34–36 Weeks of Gestation and the Associated Adverse Perinatal Outcomes

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1718954 ◽

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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The effects of oligohydramnios on perinatal outcomes after preterm premature rupture of membranes

Perinatal Journal ◽

10.2399/prn.21.0291005 ◽

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.

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Clinical Significance of Oligohydramnios in Patients with Preterm Premature Rupture of Membranes

Acta biomedica scientifica ◽

10.29413/abs.2021-6.2.1 ◽

2021 ◽

Vol 6 (2) ◽

pp. 9-15

Author(s):

O. M. Chistyakova ◽

L. V. Gureeva ◽

O. V. Radkov

Keyword(s):

Neonatal Intensive Care ◽

Perinatal Outcomes ◽

Main Group ◽

Control Group ◽

C Reactive Protein ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Amniotic Fluid Index ◽

Reactive Protein ◽

Preterm Premature Rupture

Background. Preterm premature rupture of membranes (PPROM) is one of the main causes of perinatal morbidity and mortality. Associated oligohydramnios may further exacerbate the condition leading to intra-amniotic inflammation and adverse obstetric and perinatal outcomes in preterm labor.Aim of the research. To determine an impact of oligohydramnios on patients with preterm premature rupture of membranes.Materials and methods. We performed a retrospective analysis of two groups of patients with PPROM: 56 patients with oligohydramnios were included in the main group, 111 patients without oligohydramnios were included in the control group. The gestational age varied from 24+0 weeks to 33+6 weeks. Amniotic fluid index, endocervical culture, leukogram and neutrophil-to-lymphocyte ratio (NLR), serum procalcitonin and C-reactive protein levels were assessed in all participants.Results. We witnessed a plethora of consequences in the group of women with PPROM and oligohydramnios: shorter latent phase, higher incidence of clinical chorioamnionitis, antenatal fetal distress, higher levels of C-reactive protein, leukocytes, neutrophils and NLR, lower level of lymphocytes, and increased growth of potentially pathogenic cervical flora. Moreover, the patients with oligohydramnios demonstrated a significantly higher rate of cesarean delivery. The combination of PPROM and oligohydramnios also take a toll on the condition of the newborns: they have lower 5-minute Apgar score and higher prevalence of respiratory distress syndrome, congenital pneumonia, and necrotizing enterocolitis. Furthermore, newborns from the main group are more likely to be admitted to the neonatal intensive care unit, compared with newborns from the control group.Conclusion. Oligohydramnios in PPROM is associated with a dramatic rise of numerous complications affecting both the women and the newborns.

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670: Perinatal outcomes in cephalic versus noncephalic singleton presentation in the setting of preterm premature rupture of membranes

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2015.10.717 ◽

2016 ◽

Vol 214 (1) ◽

pp. S354-S355

Author(s):

Lynn M. Yee ◽

William A. Grobman

Keyword(s):

Perinatal Outcomes ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture

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Perinatal outcomes after previable preterm premature rupture of membranes before 24 weeks of gestation

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0341 ◽

2018 ◽

Vol 46 (5) ◽

pp. 555-565 ◽

Cited By ~ 13

Author(s):

Verena Kiver ◽

Vinzenz Boos ◽

Anke Thomas ◽

Wolfgang Henrich ◽

Alexander Weichert

Keyword(s):

Survival Rate ◽

Pregnancy Termination ◽

Treatment Options ◽

Latency Period ◽

Perinatal Outcomes ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Mortality And Morbidity ◽

Membrane Rupture ◽

Preterm Premature Rupture

Abstract Objective: A current descriptive assessment of perinatal outcomes in pregnancies complicated by previable preterm premature rupture of membranes (pPPROM) at <24 weeks of gestation, after expectant treatment. Study design: Maternal and short-term neonatal data were collected for patients with pPPROM. Results: Seventy-three patients with 93 fetuses were hospitalized with pPPROM at 15–24 weeks’ gestation. Among these patients, 27.4% (n=20) chose pregnancy termination, 27.4% (n=20) miscarried and 45.2% (n=33) proceeded to live births. After a median latency period of 38 days, ranging from 1 to 126 days, 24 singletons and 20 multiples were live-born, of whom 79.5% (n=35) survived the perinatal period. The main neonatal sequelae were pulmonary hypoplasia (29.5%; n=13), connatal infection (56.8%; n=25), intraventricular hemorrhage (25%; n=11; resulting in five neonatal deaths) and Potter’s syndrome (15.9%; n=7). Nine newborns died, within an average of 2.8 days (range, 1–10 days). The overall neonatal survival rate was 51.5% – including miscarriages but not elective terminations. The intact survival rate was 45.5% of all live-born neonates. Conclusions: Even with limited treatment options, overall neonatal survival is increasing. However, neonatal mortality and morbidity rates remain high. The gestational age at membrane rupture does not predict neonatal outcome.

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