Predictors of Short Latency Period Exceeding 48 h after Preterm Premature Rupture of Membranes (original) (raw)
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The Journal of pediatrics, 2017
To assess the impact of latency duration on survival, survival without severe morbidity, and early-onset sepsis in infants born after preterm premature rupture of membranes (PPROM) at 24-32 weeks' gestation. This study was based on the prospective national population-based Etude Épidémiologique sur les Petits Ȃges Gestationnels 2 cohort of preterm births and included 702 singletons delivered in France after PPROM at 24-32 weeks' gestation. Latency duration was defined as the time from spontaneous rupture of membranes to delivery, divided into 4 periods (12 hours to 2 days [reference], 3-7 days, 8-14 days, and >14 days). Multivariable logistic regression was used to assess the relationship between latency duration and survival, survival without severe morbidity at discharge, or early-onset sepsis. Latency duration ranged from 12 hours to 2 days (18%), 3-7 days (38%), 8-14 days (24%), and >14 days (20%). Rates of survival, survival without severe morbidity, and early-ons...
Neonatal outcomes are associated with latency after preterm premature rupture of membranes
Journal of Perinatology, 2012
Objective: To determine factors associated with latency time to birth after preterm premature rupture of membranes (PPROM) and the impact on neonatal outcomes. Study Design: Data on singleton pregnancies with PPROM (n ¼ 1535 infants) were prospectively collected in a computerized perinatal/neonatal database at a tertiary care perinatal center. Latency was characterized as p72h versus >72 h after PPROM. Result: The percentage of women with latency to birth >72 h decreased from 67% in very preterm (gestational age (GA) 25 to 28 weeks) to 10% in late preterm women (GA 33 to 36 weeks). PPROM women with latency p72 h were more likely to have pregnancy-induced hypertension and birth weight <3%; PPROM women with latency >72 h were more likely to have received steroids and develop clinical chorioamnionitis. PPROM <32 weeks GA with latency p72 h was associated with a twofold higher incidence of severe neonatal morbidity, while PPROM between 29 to 34 weeks GA and latency p72 h was associated with a higher incidence of moderate neonatal morbidity. Conclusion: A latency period >72 h was associated with a decreased incidence of adverse neonatal outcomes up to 32 weeks GA for severe and 34 weeks GA for moderate morbidity indices.
Journal of Obstetrics, Gynecology and Cancer Research, 2022
Background & Objective: Premature preterm rupture of membranes (PPROM) occurs in about 2-5% of singleton pregnancies and is known to cause one-third of preterm births. Our primary aim was to determine the maternal and neonatal outcomes in PPROM cases in mothers with a gestational age of less than 37 weeks. Materials & Methods: In this prospective cross-sectional study, eligible singleton women between 24+0-37+6 weeks of gestation with the PPROM enrolled who had referred to Ayatollah Rouhani Hospital in Babol, Iran, during the years 2019-2020. Maternal and neonatal outcomes were obtained by the checklist. Results: The mean age of the studied mothers was 29.3± 6.19 years, and their mean body mass index was 30.6 ±5. The incidence of chorioamnionitis at the gestational age of >32 weeks was more than that in women at gestational age equal to or over 32 weeks (P≤0.0001). Vaginal bleeding was almost more than twice as high in women with a gestational age of less than 32 weeks compared t...
Scientific Reports, 2019
Preterm premature rupture of membranes (PPROM) is associated with an increased risk of serious maternal, fetal, and neonatal morbidities. We compared neonatal outcomes of women with PPROM before 34 +0 weeks of gestation according to inpatient or outpatient management policy. 587 women with PPROM >48 hours, 246 (41.9%) in the group with an inpatient care policy (ICP) and 341 (58.1%) in the group with an outpatient care policy (OCP), were identified in France, from 2009 to 2012. Neonatal outcomes were compared between the two groups using logistic regression. A second analysis was performed to compare inpatient care and effective outpatient care (discharge from hospital) through propensity score matching. The outcome was a neonatal composite variable including one or more of the neonatal morbidity complications. The perinatal composite outcome was 14.6% with the ICP and 15.5% with the OCP (p = 0.76). After using the 1:1 ratio propensity score matching, effective outpatient care was not associated with a significantly higher risk of the perinatal composite outcome (OR 0.88, CI 0.35 to 2.25; p = 0.80) compared with inpatient care. Outpatient care is not associated with an increased rate of obstetric or neonatal complications and can be an alternative to hospital care for women with uncomplicated ppRoM.
International Journal of Clinical Obstetrics and Gynaecology, 2020
Introduction: Identification of predictive factors for the duration of the latency period may help obstetrician in risk stratification and providing consultation for women presenting with PPROM. Correct diagnosis and timely intervention is the bottom line to strike a delicate issue of prematurity thereby optimizing the feto-maternal outcome. Material and Methods: A total of 51 patients presented with PPROM to department of obstetrics and gynaecology TMMC & RC, Moradabad during period July 2018-2019. After detailed history and examination, patients were investigated and evaluated for various factors affecting the duration of latency period in patients with PPROM. Results: About sixty percent of females presenting with PPROM were in lower age group with mean age of 23.07 +/-4.27 years, low body mass index with mean BMI of 20.7 kg/m2 and belonging to low socio economic group. All clinical and investigative parameters of infection were related to decreased latency period. Conclusion: Prevention of PPROM is challenging, however incidence can be reduced only by identifying pregnant women at risk and providing adequate preventive counselling, monitoring and adequate treatment.
Maternal and neonatal outcome related to delivery time following premature rupture of membranes
International Journal of Gynecology & Obstetrics, 1997
Objective: To evaluate neonatal and maternal outcomes of PROM deliveries with regard to the time elapsed since preterm rupture of membranes (PROM) to delivery. Method: According to the time elapsed since PROM to delivery we divided all singleton deliveries with PROM after the completed 34th week of gestation (N = 35 419), which occurred in Slovenia between 1988 and 1994, into four groups: within 12 h, within 13-24 h, within 25-48 h, and over 48 h after PROM. The analysis was focused on the management of labor, neonatal and maternal infections and perinatal hypoxia with regard to the elapsed time. The Kruskal-Wallis analysis of variance, the Pearson chi-square test, Spearman rank correlation test, and the logistic regression test were used. Results: With increasing time elapsed since PROM to delivery we found significantly increased incidences of induced labor, operative delivery, fetal distress, poorer fetal condition at birth, neonatal infections, and minor maternal infections. Conclusion: We may conclude that the best neonatal and maternal outcomes are obtained if delivery occurs within 12 h after PROM. 0 1997 International Federation of Gynecology and Obstetrics
Frontiers in reproductive health, 2022
Background: One of the most critical functions of the fetal membranes is to remain intact until the onset of labor to maintain the protective intrauterine fluid environment. In most pregnancies, spontaneous rupture usually occurs near the end of the first stage of labor. Preterm premature membrane rupture (PROM) occurs when the fetal membrane ruptures before 37 weeks of pregnancy, and it contributes to adverse maternal, fetal, and neonatal outcomes. Therefore, this study aimed to determine the association of determinant factors with adverse perinatal outcomes. Methods: A prospective cohort study was conducted on pregnant women with preterm premature membrane rupture (n = 160) attending the teaching hospitals at Addis Ababa University. Socio-demographic and obstetric risk factors with adverse perinatal outcomes include the 5th minute Apgar score, neonatal intensive care unit (NICU) admission, early-onset neonatal sepsis (EONS), respiratory distress syndrome (RDS), perinatal mortality, Chorioamnionitis, and placental abruption were assessed. SPSS version 24, t-test, χ 2 test, and logistic regression analysis were used. P-values <0.25 in the bivariate and p < 0.05 in the multiple logistic regression were considered statistically significant. Results: The preterm (PROM) rate was 2.2% with perinatal mortality rate of 206/1,000. Gestational age (GA) at delivery was the determinate for low Apgar score at the 5th minute (AOR: 7.23; 95% CI, 1.10, 47.6; p = 0.04).
American Journal Of Obstetrics & Gynecology Mfm, 2020
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Can we predict preterm delivery in patients with premature rupture of membranes?
Archives of Gynecology and Obstetrics, 2019
Purpose To characterize the parameters that predict preterm delivery in patients with preterm, premature rupture of membranes. Methods This retrospective cohort study included women diagnosed with preterm premature rupture of membranes at 24-34 weeks gestation. Demographics, medical history, laboratory tests, and delivery data were reviewed. Results Among 258 patients with preterm, premature rupture of membranes during the study period, 141 (54.7%) met the inclusion criteria. Therefore, the final cohort included 141 (54.78%) women, among whom, 32 (22.7%) delivered within the first 24 h of ROM and 109 (77.3%) delivered after 24 h. Univariant analysis revealed that advanced gestational age at the time of preterm, premature rupture of membranes, larger cervical dilation and leukocyte count at admission had significant effects on the likelihood of labor within 24 h. Analysis of the differences between each patient at admission to 24 h before labor in heart rate, temperature (fever), leukocyte counts and amniotic fluid color revealed significant changes in heart rate (P < 0.001), leukocyte count (P < 0.001) and in amniotic fluid from clean to meconium or bloody (P < 0.001). There was no significant change in elevated temperature (P = 0.065). Conclusions Our findings indicate that minimal changes in heart rate, body temperature (fever), leukocyte count and amniotic fluid color, within normal ranges, appear 24 h before delivery, among women with preterm, premature rupture of membranes and prolonged latency period. Increased attention to these changes might enable better follow-up and timing of delivery for patients with preterm, premature rupture of membranes before 34 weeks gestation.