Prediction of Admission to Delivery Time by Transvaginal Ultrasonographic Assessment of the Cervix in Cases of Preterm Prelabour Rupture of Membranes

Abstract

Background: Preterm Premature Rupture of Membranes (PPROM) heralds about 30% of cases with spontaneous preterm births. Latency in PPROM is delineated as the time interval between PROM and delivery. It might be beneficial to predict this latency period as it may help to make a decision concerning in-utero transfer of fetus to better neonatal centers with advanced facilities and to administer corticosteroids in favor of fetal lung maturity. Objective: The aim of the current study was to assess the usefulness of measuring the cervical parameters by transvaginal sonography mainly cervical length and posterior cervical angle, in predicting the interval from admission to delivery in women with (PPROM). Subjects and methods: This study was conducted at Kafr El- Shiekh General Hospital and Al-Azhar University Hospitals and included 100 pregnant women with a singleton pregnancy of gestational age between 28-34 weeks and PPROM presenting within 24 hours and not in labour. Results: showed non-significant differences between the mean of PCA among different groups (P>0.05). Nevertheless, the results indicated that amniotic fluid index (AFI) increased significantly in patients with latency period >7days group (P<0.001). Furthermore, the mean Cervical length (CL) was observed to increase in PPROM patients’ group with high latency period. The latency period had significant positive correlation with AFI and cervical length (p<0.05). Also, it had significant negative correlation with birth weight, gestational age at hospitalization, CRP, and TLC, and neonatal sepsis (p<0.05). Conclusion: It could be concluded that assessment of Cervical length via transvaginal sonography is a valuable tool in the evaluating the interval between rupture of membranes and delivery in women with PPROM.