Abstract
BackgroundOur purpose was to determine whether AFI<5 cm after preterm premature rupture of the membranes (PPROM) is associated with an increased risk of perinatal morbidity.MethodsWe performed a prospective cohort study of 95 singleton pregnancies complicated by preterm premature rupture of the membranes (PPROM) with delivery between 26 and 34 weeks gestation.Patients were categorized in two groups on the basis of amniotic fluid index<5, (AFI<5 cm)(n = 26) or AFI ≥ 5 cm (n = 69). Categorical data were tested for significance with the χ2 and Fisher exact tests. Continuous data were evaluated for normal distribution and tested for significance with the student t test.All 2-sided p values < 0.05 were considered significant.ResultsBoth groups were similar with respect to selected demographics, gestational age at rupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to selected variable, latency until delivery, early onset neonatal sepsis, RDS and neonatal death. Patients with AFI<5 cm demonstrated greater frequency of C/S delivery for non reassuring fetal tests (23%vs 2.8%) (p = 0.001). Our study demonstrated that patients in group I had a significant increase in the frequency of clinical chorioamnionitis (P < 0/001). Post partum infections were not seen in 2 groups.ConclusionsAn AFI<5 cm after PPROM between 26 and 34 weeks gestation is associated with an increased risk of maternal infections and frequency of C/S.
Highlights
Our purpose was to determine whether AFI
All 2-sided p values < 0.05 were considered significant. Both groups were similar with respect to selected demographics, gestational age at rupture of the membranes, gestational age at the delivery, birth weight. Both groups were similar with respect to selected variable, latency until delivery, early onset neonatal sepsis, respiratory distress syndrome (RDS) and neonatal death
An AFI
Summary
We performed a prospective cohort study of infants delivered between 26 weeks – 34 weeks gestation after preterm premature rupture of the membranes. Indications for delivery included: labor, the diagnosis of clinical chorioamnionitis or non-reassuring fetal test results. The 2 groups were compared for demographic characteristics, the estimated gestation age at both rupture of the membranes and delivery, latency until delivery, mode of delivery, birth weight, the development of clinical chorioamnionitis, postpartum endometritis, early onset neonatal sepsis and respiratory distress syndrome. The clinical diagnosis of chorioamnionitis was made in presence of two or more of the following criteria: maternal fever greater than 38 C, maternal tachycardia (120 beats per minute or more), leukocytosis (greater than or equal to 20,000/mm white blood cell), fetal tachycardia (greater than 160 beats per minute), uterine tenderness, and foul-smelling amniotic fluid. All patients had an ultrasonographic examination, which included confirmation of the estimated gestational age, and cumulative 4 guardant AFI measurements, as previously described by Phelan et al [3]. All 2-sided p values
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