The Correlations Between Premature Rupture of Membranes and Gestational Age with The Incidence of Asphyxia Neonatorum

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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Hubungan Ketuban Pecah dengan Kejadian Asfiksia Neonatorum di RSUD Kabupaten Kediri Tahun 2016

Jurnal Kebidanan Midwiferia ◽

10.21070/mid.v3i2.1467 ◽

2017 ◽

Vol 3 (2) ◽

pp. 19

Author(s):

Yanu Yufita Lestariningsih

Keyword(s):

Public Hospital ◽

Simple Random Sampling ◽

Fetal Membrane ◽

P Value ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Chi Square ◽

Asphyxia Neonatorum ◽

Chi Square Test ◽

Almost All

Premature rupture of membranerevolves 5-10% from all birth. Impact a birth premature that espoused broken fetal membrane early causess 12-15% asphyxia neonatorum. The purpose of the study to determine the correlation between premature rupture of membrane with the incidence of asphyxia neonatorum. The research method used is analytic with retrospective cohort approach with independent variable of premature rupture of membrane, dependent variable asphyxia neonatorum. The study was conducted on 7 June to 12 July 2017. The population of 1519 mothers inregional public hospital of Kediri regency 2016. Sample 139 respondents, taken by simple random sampling, was analyzed by Chi Square test with a significant of 0.05. Result of research most of respondent with rupture of membrane counted 46 respondents, almost all respondents that is 82.6% gave birth baby with asphyxia. From result of Chi Square test obtained by result of p-value equal to 0.000 (<0.05), result of coefficient of contingency (C) equal to 0.639 with closeness strong relation, so H1 received H0 rejected which means there is significant relation with closeness strong between premature rupture of membrane with asphyxia neonatorum inregional public hospital of Kediri regency 2016. Relative Risk (RR) 1.65 which means the possibility of a baby experiencing asphyxia neonatorum of 1.65 times in maternal who experience premature rupture of membranes compared to mothers who did not experience premature rupture of membranes.

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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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Patterns of placental pathology in preterm premature rupture of membranes

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174413000056 ◽

2013 ◽

Vol 4 (3) ◽

pp. 249-255 ◽

Cited By ~ 7

Author(s):

J. Armstrong-Wells ◽

M. D. Post ◽

M. Donnelly ◽

M. J. Manco-Johnson ◽

B. M. Fisher ◽

...

Keyword(s):

Gestational Age ◽

Pathological Finding ◽

Neonatal Outcomes ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Exact Test ◽

Preterm Premature Rupture ◽

Chorionic Plate ◽

Adverse Neonatal Outcomes ◽

Insight Into

Inflammation is associated with preterm premature rupture of membranes (PPROM) and adverse neonatal outcomes. Subchorionic thrombi, with or without inflammation, may also be a significant pathological finding in PPROM. Patterns of inflammation and thrombosis may give insight into mechanisms of adverse neonatal outcomes associated with PPROM. To characterize histologic findings of placentas from pregnancies complicated by PPROM at altitude, 44 placentas were evaluated for gross and histological indicators of inflammation and thrombosis. Student's t-test (or Mann–Whitney U-test), χ2 analysis (or Fisher's exact test), mean square contingency and logistic regression were used when appropriate. The prevalence of histologic acute chorioamnionitis (HCA) was 59%. Fetal-derived inflammation (funisitis and chorionic plate vasculitis) was seen at lower frequency (30% and 45%, respectively) and not always in association with HCA. There was a trend for Hispanic women to have higher odds of funisitis (OR = 5.9; P = 0.05). Subchorionic thrombi were seen in 34% of all placentas. The odds of subchorionic thrombi without HCA was 6.3 times greater that the odds of subchorionic thrombi with HCA (P = 0.02). There was no difference in gestational age or rupture-to-delivery interval, with the presence or absence of inflammatory or thrombotic lesions. These findings suggest that PPROM is caused by or can result in fetal inflammation, placental malperfusion, or both, independent of gestational age or rupture-to-delivery interval; maternal ethnicity and altitude may contribute to these findings. Future studies focused on this constellation of PPROM placental findings, genetic polymorphisms and neonatal outcomes are needed.

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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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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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