scholarly journals Lower genital tract infections in preterm premature rupture of membranes and preterm labor: a case-control study from Vietnam

2021 ◽  
Vol 15 (06) ◽  
pp. 805-811
Author(s):  
Quoc Huy Vu Nguyen ◽  
Hung Nam Le ◽  
Van Anh Ton Nu ◽  
Nguyen Dac Nguyen ◽  
Minh Tam Le
Keyword(s):  
Preterm Labor ◽  
Case Control Study ◽  
Aerobic Bacteria ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Group 2 ◽  
Control Study ◽  
Group 1

Introduction: This study aimed to determine the incidence of lower genital infections and related factors in preterm premature rupture of membranes (PPROM) and preterm labor. Methodology: A case-control study was conducted on pregnant women who were admitted to the Hospital of Hue University of Medicine and Pharmacy, Vietnam between November 2017 and May 2019. Cases from 22 to 36 gestational weeks were included as group 1 (patients with preterm labor and intact membranes) or as group 2 (those with PPROM). The control group included women with singleton pregnancies who were matched on gestational age and recruited concurrently with the study cases. Gram stain was perfomed to identify Lactobacillus, Gardnerella, mobiluncus, Candida, and leucocytes. Trichomonas vaginalis was detected by wet mount. Cultures of vaginal secretions and aminotic fluid were performed to identify aerobic bacteria. Results: Bacterial vaginosis was higher in group 1 (28.9%) compared to control (11.4%). The incidence of isolated aerobic bacteria was 44.1% in group 2, 11.1% in group 1, and 12.7% in the control group (p < 0.001). Fungal infection was not shown to be a risk factor for preterm labor (p = 0.990), whereas, bacterial vaginosis was (OR = 3.16; 95%CI = 1.23-8.15; p = 0.016). Isolated aerobic bacteria were associated with premature rupture of membranes (OR = 5.45; 95%CI = 2.11-14.05; p < 0.001). Conclusions: Bacteria vaginosis increased the risk of preterm labor and preterm premature rupture of membranes. Isolated aerobic bacteria were related to PPROM, while fungal infection was not associated with preterm labor.

Interdelivery Interval and Medically Indicated Preterm Delivery

2018 ◽  
Vol 36 (01) ◽  
pp. 086-089
Author(s):  
William Grobman ◽  
Annie Dude
Keyword(s):  
Preterm Delivery ◽  
Preterm Labor ◽  
Case Control Study ◽  
Placental Abruption ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Spontaneous Preterm Delivery ◽  
Medical Indications ◽  
Control Study

Objective The objective of this study was to examine whether a medically indicated preterm delivery is relatively more likely following longer interdelivery intervals. Study Design This is a case–control study of women with two consecutive deliveries of a live singleton at the same institution between 2005 and 2015, with the subsequent delivery occurring preterm. Preterm deliveries were classified as spontaneous if women delivered following preterm labor, preterm premature rupture of membranes, or placental abruption. Preterm deliveries were classified as medically indicated if women underwent delivery for fetal or maternal medical indications. Interdelivery interval was categorized as < 18, 18 to 59, and 60 months or more. Characteristics of women who had a medically indicated versus spontaneous preterm delivery were compared. Results Of the 1,276 women, 25.6% had a medically indicated preterm delivery and 74.4% had a spontaneous preterm delivery. Compared with women with an interdelivery interval of 18 to 59 months (of whom 25.7% had a preterm delivery for medical indications), women with a shorter interdelivery interval were less likely (19.3%), while women with a longer interdelivery interval were more likely (37.4%; p = 0.003) to have a medically indicated preterm delivery. This relationship persisted even when accounting for other factors. Conclusion Preterm deliveries are more likely to be medically indicated as the interdelivery interval lengthens.

scholarly journals Neutrophil–lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes: a case-control study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Greta Balciuniene ◽  
Greta Kvederaite-Budre ◽  
Violeta Gulbiniene ◽  
Irena Dumalakiene ◽  
Rita Viliene ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
P Value ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Preterm Premature Rupture ◽  
Significant Difference ◽  
Control Study

Abstract Background The neutrophil-lymphocyte ratio (NLR) is easily calculated blood test parameter, which can be used as marker to predict many inflammatory disorders. The aim of this study was to assess and compare the NLR in maternal blood with the white blood cell (WBC) count and C-reactive protein (CRP) concentration for the prediction of histological chorioamnionitis. Methods This was a case-control study of 137 woman with preterm premature rupture of membranes (PPROM) at a gestational age between 22+ 0 and 34+ 6 weeks. Blood samples, collected less than 48 h before delivery and at least 48 h after the administration of corticosteroids, were selected for the analysis. The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Chorioamnionitis was diagnosed by the histopathological evaluation of placental membranes and chorionic plate. Results Patients with diagnosed histological chorioamnionitis (HCA) had significantly higher levels of WBC, CRP and NLR (p-value < 0.001). Levels of WBC, CRP and NLR predicted HCA with an area under the curve (AUC) of 0.81, 0.81 and 0.89, respectively. NLR had statistically significantly higher AUC than WBC, but no significant difference was found between AUCs of NLR and CRP. The cut-off level of NLR was found to be 5,97, which had a sensitivity of 77 % and a specificity of 95 %. Conclusion NLR has a good predictive value for HCA and could be used as an additional diagnostic marker for predicting histological chorioamnionitis in cases with preterm premature rupture of membranes before 34 weeks of gestation.

The Association between Shirodkar Cerclage and Preterm Premature Rupture of Membranes in Singleton Pregnancies

2020 ◽  
Author(s):  
Alberto Muniz Rodriguez ◽  
Andrew Pastor ◽  
Nathan S. Fox
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Uterine Anomalies ◽  
Underlying Risk ◽  
Singleton Pregnancies

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

scholarly journals Obstetric Management of Copperhead Snake Envenomation in Pregnancy: A Case Report

2019 ◽  
Vol 2 (2) ◽  
pp. 35-41
Author(s):  
Michelle J. Wang ◽  
Michelle Y. Lu ◽  
Elizabeth B. Ausbeck ◽  
Lorie M. Harper
Keyword(s):  
Case Report ◽  
Preterm Labor ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Fetal Outcomes ◽  
Snake Envenomation ◽  
Preterm Premature Rupture ◽  
Antenatal Steroids ◽  
Obstetric Management ◽  
In Pregnancy

Snakebites in pregnancy can result in significant maternal and fetal harm; however, the literature to guide management of this rare obstetric complication remains limited. We describe our approach to envenomation in pregnancy based on the currently available evidence. A 27-year-old G2P1 female presented at 27 weeks’ gestation after suffering a copperhead snakebite. She received antivenom and antenatal steroids without adverse maternal or fetal event. Antenatal testing was reassuring throughout admission, and she was discharged home with plans for close outpatient surveillance. She later developed preterm premature rupture of membranes and preterm labor, with delivery of a live infant at 33 weeks’ gestation. The risk of adverse maternal and fetal outcomes following snake envenomation in pregnancy may warrant closer antenatal surveillance than has been previously described.

Risk factors for preterm premature rupture of fetal membranes: A multicenter case-control study

1990 ◽  
Vol 163 (1) ◽  
pp. 130-137 ◽  
Author(s):  
James H. Harger ◽  
Ann W. Hsing ◽  
Ruth E. Tuomala ◽  
Ronald S. Gibbs ◽  
Philip B. Mead ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Fetal Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Control Study
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