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 Fetomaternal Outcome in Preterm Premature Rupture of Membrane

2014 ◽  
Vol 5 (1) ◽  
pp. 18-21 ◽  
Author(s):  
Manju Puri ◽  
Minakeshi Rana ◽  
Sharda Patra ◽  
Shubha Sagar Trivedi
Keyword(s):  
Gestational Age ◽  
Latency Period ◽  
Intrauterine Fetal Death ◽  
Premature Rupture ◽  
Complete Evaluation ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Maternal Morbidity And Mortality ◽  
The Difference ◽  
Prophylactic Use

Abstract This prospective observational study was carried out to study the fetomaternal outcome in women with preterm premature rupture of membrane (PPROM) between 24 and 36 weeks of gestation. Materials and methods A total of 150 pregnant women between 24 and 36 weeks gestation with PROM were subjected to detailed history and examination. Each patient was followed till her delivery and fetomaternal outcome was recorded gestation-wise between 24 and 28 weeks (n = 15), 28 and 32 weeks (n = 30), 32 and 34 weeks (n = 90), and 34 and 36 weeks (n = 15). Result The mean latency period from membrane rupture to delivery decreased from 15 days at 24 to 28 weeks, 11 days at 28 to 32 weeks to 4.4 days at 32 to 34 weeks to 2.1 days at 34 to 36 weeks. Majority of women delivered vaginally. The rate of spontaneous labor increased as the gestational age at admission increased, the difference between rate of spontaneous labor of 67% at 28 to 32 weeks and 86% at 34 to 36 weeks was statistically significant (p = 0.001). The indications for induction of labor were intrauterine fetal death, gross oligohydramnios, and clinical chorioamnionitis. The most common complication was clinical chorioamnionitis (6%) and postpartum sepsis (6%). The perinatal outcome was favorable in majority of cases and improved with the increase in gestational age at PROM. The overall perinatal mortality was 9.3%. Conclusion Management of PPROM involves complete evaluation of risks and benefits of conservative management. Wherever possible, the treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and steroids thereby reducing fetal-maternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis. How to cite this article Rana M, patra s, Puri M, Trivedi SS. Fetomaternal Outcome in Preterm Premature Rupture of Membrane. Int J Infertil Fetal Med 2014;5(1):18-21.

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

2018 ◽  
Vol 46 (5) ◽  
pp. 555-565 ◽  
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.

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

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.

scholarly journals Preterm Premature Rupture of Membranes – Inpatient Versus Outpatient Management: an Evidence-Based Review

2021 ◽  
Author(s):  
Werner Rath ◽  
Holger Maul ◽  
Ioannis Kyvernitakis ◽  
Patrick Stelzl
Keyword(s):  
Pregnant Women ◽  
Latency Period ◽  
Neonatal Morbidity ◽  
Future Research ◽  
Evidence Based ◽  
Outpatient Management ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Maternal Complications ◽  
Preterm Premature Rupture

AbstractAccording to current guidelines, inpatient management until birth is considered standard in pregnant women with preterm premature rupture of membranes (PPROM). With the increasing burden on obstetric departments and the growing importance of satisfaction and right to self-determination in pregnant women, outpatient management in PPROM is a possible alternative to inpatient monitoring. The most important criterion for this approach is to ensure the safety of both the mother and the child. Due to the small number of cases (n = 116), two randomised controlled trials (RCTs) comparing inpatient and outpatient management were unable to draw any conclusions. By 2020, eight retrospective comparative studies (cohort/observational studies) yielded the following outcomes: no significant differences in the rate of maternal complications (e.g., chorioamnionitis, premature placental abruption, umbilical cord prolapse) and in neonatal morbidity, significantly prolonged latency period with higher gestational age at birth, higher birth weight of neonates, and significantly shorter length of stay of preterm infants in neonatal intensive care, shorter hospital stay of pregnant women, and lower treatment costs with outpatient management. Concerns regarding this approach are mainly related to unpredictable complications with the need for rapid obstetric interventions, which cannot be performed in time in an outpatient setting. Prerequisites for outpatient management are the compliance of the expectant mother, the adherence to strict selection criteria and the assurance of adequate monitoring at home. Future research should aim at more accurate risk assessment of obstetric complications through studies with higher case numbers and standardisation of outpatient management under evidence-based criteria.

scholarly journals Neonatal Outcomes In Women With Preterm Premature Rupture of Membranes At Periviable Gestational Age

2022 ◽  
Author(s):  
Jacky Herzlich ◽  
Laurence Mangel ◽  
Ariel Halperin ◽  
Daniel Lubin ◽  
Ronella Marom
Keyword(s):  
Survival Rate ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neonatal Outcomes ◽  
High Survival ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Membrane Rupture ◽  
Preterm Premature Rupture ◽  
Gestational Week

Abstract Purpose: To examine the outcomes of preterm infants born to women with preterm premature rupture of membranes at periviable gestational age.Methods: This is a retrospective study analyzing data on singleton deliveries complicated by prolonged premature rupture of membranes occurring before 24 weeks of gestation. Neonatal outcomes including birth weight, Apgar score, retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia, necrotizing enterocolitis, hearing impairment and mortality were evaluated.Results: Ninety four preterm infants who were born after a prolonged premature rupture of membranes of at least 7 days were included in the study.Median gestational week at onset of membrane rupture was 27.1 ± 4.2 weeks (range 17 - 33) and median latency period in days was 16 ± 21.8 (range 7 - 105). We found that the survival rate to discharge within neonates born after prolonged rupture of membrane at gestational week less than 24 weeks is 79.2%. These neonates did not show an increased rate of major morbidities compared to neonates born following membrane rupture at gestational week 24 to 27. Conclusion: We described a high survival rate without major morbidities following prolonged preterm membrane rupture before viability.

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 Perinatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes during the late preterm period

2021 ◽  
Author(s):  
Hayan Kwon ◽  
Suk Ho Kang ◽  
Hyun Sun Ko ◽  
Ja Young Kwon ◽  
Han-sung Kwon ◽  
...  
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Death ◽  
Expectant Management ◽  
Neonatal Outcomes ◽  
Late Preterm ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Maternal Sepsis

Abstract The aim of this study is to evaluate maternal and neonatal outcomes following immediate delivery or expectant management of preterm premature rupture of membranes (PPROM) during the late preterm period at 34+ 0–36+ 6 weeks of pregnancy. We conducted a retrospective study on singleton pregnancies with PPROM during the late preterm period using medical records at twelve tertiary medical centres in Korea from January 2007 to December 2016. Data on demographic characteristics and outcome measures were collected. The primary outcomes were maternal sepsis for maternal outcome and neonatal sepsis and neonatal death for neonatal outcomes. Of the 1,072 women, 782 cases (72.9%) were assigned to the immediate delivery group, and 290 cases (27.1%) were categorized into the expectant management group. There was a significant difference in the rate of clinical neonatal sepsis (immediate delivery, 3.8% vs expectant management, 15.8%; p < 0.0001), however, no differences in maternal sepsis (p = 0.5424), culture-proven neonatal sepsis (p = 0.2108), or neonatal death (p = 0.3899) were observed. In conclusion, expectant management in women with PPROM during the late preterm period does not increase the risk of severe maternal and neonatal morbidities and mortality; however, careful monitoring for chorioamnionitis or fetal compromise should be considered during expectant management.

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.

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