scholarly journals 182 Cases of Premature Rupture of Membranes and Treatment Strategy Analysis

2015 ◽  
Vol 4 (4) ◽  
pp. 23
Author(s):  
Wenxian Dai

<p><strong>Objective: </strong>Related factors and treatment strategies of premature rupture of membranes (PROM) were discussed. <strong>Method: </strong>Retrospective analysis of 182 cases of preterm premature rupture of membranes (PPROM) from Yanshan County Hospital from January 2010 to October 2015. <strong>Results</strong><strong>: </strong>From the 182 cases [123 vaginal delivery and 59 cesarean section (C-section)], there were 79.12% PROM cases were detected in the presence of risk factors. Neonatal mortality and complications were significantly higher at 28−33 + 6 weeks of pregnancy than those at 34−36 + 6 weeks, 28−33 + 6 weeks, and 34−36 + 6 weeks. <strong>Conclusion: </strong>In order to improve the survival rate of newborns, the related factors leading to PPROM should be treated.</p>

2013 ◽  
Vol 28 (2) ◽  
pp. 108-111 ◽  
Author(s):  
Nihal Al Riyami ◽  
Intisar Al-Ruheili ◽  
Fatma Al-Shezawi ◽  
Murtadha Al-Khabori

2018 ◽  
Vol 46 (5) ◽  
pp. 555-565 ◽  
Author(s):  
Verena Kiver ◽  
Vinzenz Boos ◽  
Anke Thomas ◽  
Wolfgang Henrich ◽  
Alexander Weichert

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.


2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods: This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusion: Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.


Author(s):  
Alberto Muniz Rodriguez ◽  
Andrew Pastor ◽  
Nathan S. Fox

Objective The aim of this study was to estimate if preterm premature rupture of membranes in women with cerclage is due to the cerclage itself or rather the underlying risk factors for preterm birth in this population. Study Design This was a retrospective cohort study of singleton pregnancies who underwent Shirodkar cerclage by a single maternal–fetal medicine practice between 2005 and 2019. The control group was an equal number of randomly selected women with a singleton gestation who had a prior preterm birth and were treated with 17-OH-progesterone but no cerclage. Patients with major uterine anomalies or fetal anomalies were excluded. The primary outcome was preterm premature rupture of membranes prior to 34 weeks. Chi-square and logistic regression were used. Results A total of 350 women with cerclage (154 [44%] history-indicated, 137 [39%] ultrasound-indicated, and 59 [17%] exam-indicated) and 350 controls were included. Preterm premature rupture of membranes prior to 34 weeks did not differ between the groups (8.9% in cerclage vs. 6.0% in controls, p = 0.149, adjusted odds ratio 0.62, 95% confidence interval: 0.24–1.64) nor between the different cerclage indications (9.1% of history-indicated, 7.3% of ultrasound-indicated, and 11.9% of exam-indicated, p = 0.582). This study had 80% power with an α error of 0.05 to detect an increase in preterm premature rupture of membranes prior to 34 weeks from 6.0% in the control group to 12.0% in the cerclage group. Conclusion Cerclage does not increase the risk of preterm premature rupture of membranes prior to 34 weeks compared with other women at increased risk of preterm birth. The observed association between cerclage and preterm premature rupture of membranes is likely due to underlying risk factors and not the cerclage itself. The risk of preterm premature rupture of membranes prior to 34 weeks in women with cerclage is 10% or less and does not appear to differ based on cerclage indication. Key Points


2021 ◽  
Vol 11 (03) ◽  
pp. 233-251
Author(s):  
Dobgima Walter Pisoh ◽  
Claude Hector Mbia ◽  
William Ako Takang ◽  
Obelda Guiswe Beltus Djonsala ◽  
Mbah Cypress Munje ◽  
...  

Author(s):  
Mehmet Çınar ◽  
Hakan Timur ◽  
Ali İrfan Güzel ◽  
Aytekin Tokmak ◽  
Burak Ersak ◽  
...  

<p><strong>OBJECTIVE:</strong> To evaluate clinical characteristics of surgical-site infections (SSIs) following cesarean section (CS) and to identify infection rates and risk factors associated with SSIs following cesarean section. <br /><strong>STUDY DESIGN:</strong> A total of 197 patients who underwent cesarean and complicated with SSIs was evaluated during hospital stay or within 30 days following cesarean section by readmission to the hospital or by post discharge survey. The clinical characteristics, subsequent microbiological culture results and management were recorded. <br /><strong>RESULTS:</strong> There were 34 (17.25%) patients complicated with preeclampsia and 26 (13.17%) gestational diabetes mellitus (GDM) in the study group. Preterm rupture of membranes (PROM) rate was 17.31% and mean rupture period were 6.61 hours. In the study population, 66 patients had positive culture results. The most isolated microorganism was S. Aureus (n=13, 19.7%). Preeclampsia, GDM and PROM rates were statically significant high in patients with positive culture results (p&lt;0.05). There were 31 patients complicated with PROM in the study group. The rates of positive culture results were significantly increased by PROM (mean 45%, p&lt;0.05).<br /><strong>CONCLUSION:  </strong>Independent risk factors for post-cesarean SSIs are younger age, obesity, diabetes, hypertension, premature rupture of membranes. Information regarding higher rates of SSIs should be provided to obese women undergoing cesarean delivery, especially when diabetes and hypertension coexists.</p>


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