Residue amniotic fluid volume after preterm premature rupture of membranes and maternal-fetal outcome.

Abstract

To determine the relationship between the residue amniotic fluid volume after preterm premature rupture of membranes (PPROM) and maternal-fetal prognosis. One hundred and forty-five pregnant women with PPROM during 28 - 34 gestational weeks were studied, hospitalized in department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University from Jan. 2002 to Feb. 2009, and Chongqing Health Center For Women And Children from Jan. 2005 to Feb. 2009. All patients are willing to take part in these experiments. According to Amniotic fluid index (AFI) by ultrasound, patients were devided into three groups: (1) Group of oligohydramnios: AFI < 50 mm; (2) Group of borderline oligohydramnios: 50 mm </= AFI < 80 mm; (3) Group of normal amniotic fluid: 80 mm </= AFI < 180 mm. All the groups were similar with patient's age, gravidity and parity, white blood cell count (WBC), gestational age at rupture of membrane, rates of placental abruption, neonatal jaundice, neonatal hypoglycemia, neonatal respiratory distress syndrome (NRDS), neonatal hypoxic ischemic encephalopathy (HIE) and neonatal respiratory failure (RF; P > 0.05). (1) Group of oligohydramnios had a shorter latent period (P < 0.05) compared with other two groups; (2) Group of oligohydramnios had a high rates of cesarean section (69%), Intra-amniotic infection (IAI, 36%), fetal distress (19%), neonatal asphyxia (28%), early-onset neonatal sepsis (28%) and hypoxic-ischemic myocardial injury (56%) than those in Group of normal amniotic fluid (39%, 9%, 3%, 8%, 9%, 13%; P < 0.01); (3) Logistic regression analysis showed that group of oligohydramnios was an independent risk factor of IAI and early-onset neonatal sepsis (P < 0.05). Oligohydramnios after pprom is associated with the shorter latent period, as well as the increasing risks of pregnancy complications of cesarean section, IAI, fetal distress, neonatal asphyxia, early-onset neonatal sepsis and neonatal hypoxic-ischemic myocardial injury. So, the amniotic fluid volume might be an important prognostic indicator to assess the outcomes of maternal and neonatal when PPROM happened.