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.

scholarly journals Fetomaternal outcomes in conservative management of preterm premature rupture of membrane

2021 ◽  
Vol 10 (2) ◽  
pp. 691
Author(s):  
Rama Chundawat ◽  
Meenakshi Singh ◽  
Arun Gupta ◽  
Bhamini Jakhetiya ◽  
Ruhina Khan
Keyword(s):  
Gestational Age ◽  
Conservative Management ◽  
Latency Period ◽  
Fetal Distress ◽  
P Value ◽  
Complete Evaluation ◽  
E Coli ◽  
Medical College ◽  
Membrane Rupture ◽  
Prophylactic Use

Background: The management of PPROM remains controversial. Aim of this study was to determine the fetomaternal outcome in conservative management of PPROM.Methods: A prospective observational study was done on a total of 110 pregnant women between 24 and 36 weeks 6 days gestation with PPROM visiting Geetanjali medical college and hospital from February 2019 to July 2020. All the patients were subjected to detailed history and examination and followed till their delivery.Results: The incidence of PPROM in our study was 4.94%. The mean latency period from membrane rupture to delivery decreased from 12.1±14 days at >28 weeks, 5.3±7.7 days at 28-31 weeks 6 days to 1.1±1.2 days at 32 to 36 weeks 6 days. The most common indication of LSCS was fetal distress (26.31%). E. coli was the most common organism (36.36%) isolated and it was significantly associated with gestational age at PPROM (p value <0.040405). The maternal morbidity was 24.53% and was closely associated with the gestational age at PPROM (p value <0.001). The perinatal morbidity was 44.20% and perinatal mortality was 13.04% which was mainly due to RDS (33.34%).Conclusions: Management of PPROM involves complete evaluation of risks and benefits of conservative management. The treatment should be directed toward conserving the pregnancy with prophylactic use of antibiotics and corticosteroids thereby reducing fetomaternal morbidity and mortality. However, termination of pregnancy should be considered at the earliest suspicion of chorioamnionitis, septicaemia.

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.

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.

Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Joohee Choi ◽  
Jeong Woo Park ◽  
Byoung Jae Kim ◽  
Ye-Jin Choi ◽  
Jong Hee Hwang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Cervical Insufficiency ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Histologic Chorioamnionitis ◽  
Gestational Age At Delivery ◽  
The Difference

AbstractTo compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.: The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.

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.

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