scholarly journals Outcomes of prolonged preterm premature rupture of the membrane: a report of six cases

2018 ◽  
Vol 8 (1) ◽  
pp. 329
Author(s):  
Asha Dixit
Keyword(s):  
Maternal Morbidity ◽  
Complete Blood Count ◽  
Clinical Investigation ◽  
Present Report ◽  
Latency Period ◽  
Expectant Management ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Foetal Mortality ◽  
Litmus Test

Preterm premature rupture of the membranes (PROM) is associated with significant maternal morbidity and perinatal mortality. With an increasing era of infertility, the main interest of an assisted reproductive technology specialist is to increase the take-home baby rate. Here authors present report on the outcomes of prolonged preterm PROM cases facilitated with expectant management. Report is based on the medical records of six women with preterm PROM between 16-31 weeks of gestation who gave their consent to continue the pregnancy. These women were diagnosed with PROM by the litmus test and per speculum examination. Ultrasound scan and clinical investigation, which included complete blood count and C-reactive protein level, were performed in all cases. Prophylactic antibiotics were administered to prevent the infection and increase the latency period. All six babies (100%) were delivered successfully. There was no foetal mortality and maternal morbidity observed. Expectant management in preterm PROM cases can increase the survival rate and hence the take-home baby rate.

scholarly journals The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes

2014 ◽  
Vol 6 (1) ◽  
pp. 28-32
Author(s):  
Nasira Tasnim ◽  
Ghazala Mahmud ◽  
Saba Fatima
Keyword(s):  
Controlled Trial ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Management Control ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Prolongation

ABSTRACT Objective To evaluate the role of transabdominal amnioinfusion in improving the latency period and perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (PPROM). Materials and methods A randomized controlled trial was carried out at MCH Centre, Unit I, PIMS, Islamabad, from Jan 2008 to Dec 2008. Sixty women with singleton pregnancies between 28 and 32 completed weeks of gestation, complicated with PPROM was randomly allocated into two groups viz transabdominal amnioinfusion (amnioinfusion group) and expectant management (control group), within 24 hours of admission. Results The demographic characteristics were comparable in both the groups. Amnioinfusion group showed significant improvement in PPROM to delivery interval (18.47 ± 6.699 vs 8.93 ± 4.741 days; p = 0.001), neonatal birth weight (p = 0.019) and Apgar scores at 1 and 5 minutes (p = 0.007 for 1 minute and p = 0.012 for 5 minutes). There was less frequency of respiratory distress syndrome (p = 0.032), neonatal sepsis (p = 0.020) and neonatal jaundice (p = 0.002) in the amnioinfusion group. Fewer neonates were admitted to NICU (p = 0.010) and higher survival rate was found in amnioinfusion group (p = 0.023). Conclusion The treatment with transabdominal amnioinfusion in pregnancies complicated with PPROM resulted in significant prolongation of pregnancy and better neonatal outcomes as compared to women who were managed with traditional expectant management. How to cite this article Fatima S, Tasnim N, Mahmud G. The Effect of Transabdominal Amnioinfusion on Perinatal Outcomes in Preterm Premature Rupture of Membranes. J South Asian Feder Obst Gynae 2014;6(1):28-32.

scholarly journals Azithromycin as Macrolide of Choice in Patients with Preterm Premature Rupture of Membranes in Expectant Management: A Retrospective Study

2021 ◽  
Author(s):  
Fernanda Oliveira Castilhos ◽  
Gabriel Cardozo Müller ◽  
Janete Vettorazzi ◽  
Daniela Vanessa Vettori ◽  
Maria Carolina Bittencourt Costa ◽  
...  
Keyword(s):  
Median Time ◽  
Birth Rate ◽  
Latency Period ◽  
Expectant Management ◽  
Fisher Exact Test ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Kaplan Meier ◽  
Group 2 ◽  
Group 1

Abstract Background: Preterm premature rupture of amniotic membranes (PPROM) is responsible for about 30% of premature births, being associated with great neonatal morbidity and mortality. The use of antibiotics in expectant management seems to increase the latency period between PPROM and birth, as well as improving maternal and neonatal outcomes. However, short and long term benefits, and the ideal antibiotics regimen remains controversial. Objective: This study seeks to demonstrate that the use of antibiotics, with azithromycin as macrolide of choice, in expectant management reduces the birth rate in the first 48 hours after PPROM, increasing the latency period between PPROM and birth. Methods: Observational, retrospective cohort study in pregnant women with PPROM treated conservatively at the Hospital de Clínicas de Porto Alegre (HCPA), from January 2012 to December 2019. For the group that used antibiotics, the scheme was Azithromycin and Ampicillin for 48 hours, followed by Amoxicillin for 5 days, completing 7 days of treatment. Qualitative data was analyzed by Fisher exact test, and time to event analysis using Kaplan Meier estimator were used to evaluate latency to birth and Cox regression to estimate Hazard Rate. Results: 145 participants, of which 107 did not use antibiotics (group 1) and 38 used antibiotics (group 2). The 48-hour birth rate was significantly lower in the antibiotics group (33.6% in group 1 vs. 16% in group 2, p=0.04). The birth rate on patients presenting outcomes before 15 days presented a significant reduction (HR 0.6 [95% ICI 0.39 - 0.92]), as well median time to birth as seen in Kaplan Meier estimator by log-rank test. Conclusion: The use of this antibiotics regimen, with azithromicyn as macrolide of choice, reduced the birth rate in the first 48 hours, with potential clinical benefits due to the increase in the pharmacological window for corticosteroid action, among others, and increased median time to birth in first 15 days between PPROM and birth.

scholarly journals Perinatal Outcomes Associated with Latency in Late Preterm Premature Rupture of Membranes

2021 ◽  
Vol 18 (2) ◽  
pp. 672
Author(s):  
Eui Kyung Choi ◽  
So Yeon Kim ◽  
Ji-Man Heo ◽  
Kyu Hee Park ◽  
Ho Yeon Kim ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Latency Period ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Late Preterm ◽  
Premature Rupture ◽  
Antenatal Corticosteroids ◽  
Preterm Premature Rupture ◽  
Antenatal Steroids ◽  
Significant Difference

This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006–2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery ≥72 h vs. immediate delivery <72 h). Data were compared among 345 women (expectant, n = 39; immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p < 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (≥72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM.

Latency Period after Preterm Premature Rupture of Membranes: Singletons versus Twins

2021 ◽  
Author(s):  
Nigel Madden ◽  
Maria Andrikopoulou ◽  
Eve Overton ◽  
Cynthia Gyamfi-Bannerman
Keyword(s):  
Clinical Outcomes ◽  
Latency Period ◽  
Expectant Management ◽  
Small Sample ◽  
Neonatal Outcomes ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Neurodevelopmental Outcomes ◽  
Preterm Premature Rupture

Objective Several studies have evaluated the differences in duration of latency and clinical outcomes between singleton and twin pregnancies after preterm premature rupture of membranes (PPROM); however, these data are limited to single-institution analyses and based on small sample sizes. The aim of this study was to assess differences in latency and clinical outcomes in singletons versus twin gestations affected by PPROM in a large, diverse cohort of women. Study Design This is a secondary analysis of a multicenter trial of magnesium for neuroprotection in women at high risk of preterm birth. Our study included women with PPROM ≥ 24 weeks with singleton and twin gestations. We compared singleton versus twin gestation and our primary outcome was duration of latency after PPROM. Secondary outcomes included selected perinatal and neonatal outcomes including long-term neurodevelopmental outcomes. We fit a linear regression model to assess independent risk factors for latency duration. Results Our study included 1,753 women, 1,602 singleton gestations (91%) and 151 twin gestations (9%). The median latency period was significantly shorter in twins (4 [interquartile range, IQR: 1–10] vs. 7 [IQR: 3–16] days, p < 0.001) and gestational age at delivery was significantly earlier (29.3 vs. 30.1 weeks, p = 0.001). Twins were more likely to develop neonatal sepsis (20.1 vs. 13.4%, p = 0.004), but rates of chorioamnionitis and abruption did not differ. Twins were more likely to suffer from adverse short-term neonatal outcomes, had higher rates of neonatal demise (7.9 vs. 3.8%, p = 0.002), and had higher rates of cerebral palsy (7.3 vs. 3.7, p = 0.005). When adjusting for confounders, twin gestation remained an independent risk factor for shorter latency (p < 0.001). Conclusion Twin gestations affected by PPROM had shorter latency, earlier delivery, and higher rates of short- and long-term morbidity. Despite having longer latency, singleton gestations did not have higher rates of complications associated with expectant management. Key Points

scholarly journals Predictors of Short Latency Period Exceeding 48 h after Preterm Premature Rupture of Membranes

2021 ◽  
Vol 10 (1) ◽  
pp. 150
Author(s):  
Marion Rouzaire ◽  
Marion Corvaisier ◽  
Virginie Roumeau ◽  
Aurélien Mulliez ◽  
Feras Sendy ◽  
...  
Keyword(s):  
Maternal Morbidity ◽  
Latency Period ◽  
Preterm Births ◽  
Cervical Length ◽  
Short Latency ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Management Method

Background: Preterm premature rupture of membranes (PPROM) is a complication responsible for a third of preterm births. Clinical management is initially hospital based, but homecare management is possible if patients are clinically stable 48 h after PPROM. This study set out to determine factors that are predictive of short latency (delivery ≤ 7 days) exceeding 48 h after PPROM, enabling estimation of the prevalence of maternal and neonatal complications and comparison of maternal and fetal outcomes between inpatient and outpatient management. Method: This was a monocentric retrospective study conducted between 1 January 2010 and 28 February 2017 on all patients experiencing PPROM at 24 to 34 weeks + 6 days and who gave birth after 48 h. Maternal, obstetric, fetal, and neonatal variables were included in the data collected. The primary endpoint was latency, defined as the number of days between rupture of membranes and delivery. Results: 170 consecutive patients were analyzed. Short latency could be predicted by the need for tocolysis, a cervical length less than 25 mm at admission and the existence of anamnios. Outpatient follow-up was not found to lead to increased maternal morbidity or neonatal mortality. Conclusion: Our study highlights predictive factors of short latency exceeding 48 h after PPROM. Knowledge of these factors may provide justification for outpatient monitoring of patients presenting with a long cervix, absence of need for tocolysis and persistence of amniotic fluid and, thus, no risk factors after 48 h of admission.

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