Outcome In Preterm Premature Rupture Research Articles

Amniotic Fluid Volume: An Important Deciding Factor for Pregnancy Continuation in Preterm Premature Rupture of Membranes

Abstract Aims and Objectives: To find out various risk factors affecting fetomaternal outcomes in preterm premature rupture of membranes (PPROM). Materials and Methods: A prospective study after approval from the ethical committee was conducted at VMMC and Safdarjung Hospital, New Delhi, Department of Obstetrics and Gynaecology from December 2020 to May 2022 in which 100 pregnant women with preterm premature rupture of membrane between 32 and 36 weeks of gestation were enrolled. Patients were followed with Total leucocyte count (TLC), urine R/M, urine C/S, high vaginal swab C/S, and C-reactive protein along with routine antenatal care investigations. Intravenous antibiotics were given to all patients for 48 h followed by oral antibiotics for 5 days. All patients were on follow-up and managed conservatively and induction of labor was done at 37 weeks or earlier in case of fetal distress and presence of signs and symptoms of chorioamnionitis. Both mother and baby were followed till 7 days after delivery. Results: In the present study, we observed the following risk factors that had adverse effects on fetomaternal outcomes in PPROM patients. The association of oligohydramnios (amniotic fluid index [AFI] <5) with neonatal sepsis (P = 0.025) and neonatal death (P = 0.025) was found to be significant. Vaginal infection was found to be significantly associated with birth asphyxia (P = 0.024), APGAR <7 at 1 min (P = 0.015), neonatal intensive care unit (NICU) admission (P = 0.009), and postpartum hemorrhage (PPH) (P = 0.002). The association of urinary tract infection (UTI) with neonatal sepsis (P = 0.01), birth asphyxia (P = 0.005), APGAR <7 at 1 min (P = 0.001), NICU admission (P = 0.002), neonatal death (P = 0.01), and PPH (P = 0.0004) was found to be significant. We also observed that the duration from membrane rupture to delivery had no adverse effect on fetomaternal outcome, may be as we had given antibiotics to all patients from the time of admission. Conclusions: The conclusion from the present study was that oligohydramnios (AFI <5) is a significant risk factor for adverse neonatal outcomes in PPROM along with vaginal infections and UTIs. Hence, amniotic fluid volume should also be considered as an important deciding factor for pregnancy continuation in PPROM.

Relationship between Folate, B12 and Homocysteine levels and Obstetrical Outcomes in Preterm Premature Rupture of Membrane

التمزق التلقائي لأغشية الجنين قبل بدء الولادة الذي يحدث قبل اكتمال 37 أسبوعًا من الحمل ، يشار إليه على أنه تمزق الأغشية المبكر قبل الولادة . يحدث في 2٪ من حالات الحمل. يعتمد التنبؤ بـه على تحديد عوامل الخطر المرتبطة واستخدام مؤشرات حيوية محددة لمنع النتائج الضارة على الام والجنين. ان الهدف من الدراسة لمعرفة العلاقة وفهم الدور بين حامض الفوليت ، فيتامين بي 12 والهميوسستين في تمزق الغشاء الامينوسي المبكر قبل حدوث الولادة ولتحديد النتائج من تمزق الغشاء الامنيوسي على الام والطفل . تم تطبيق دراسة حالة وشواهد ، اشتملت الدراسة على 100 امرأة حامل بجنين واحد حي مع عمر حمل للمرضى يتراوح بين 24 الى 36 أسبوعًا وستة أيام من الحمل .أجريت الدراسة في قسم أمراض النساء والولادة بمستشفى الخنساء التعليمي للولادة خلال فترة خمسة أشهر وعشرة ايام من 20 / كانون الثاني إلى 1 / تموز / 2022. وشملت الدراسة 50 امرأة حامل يعانين من تمزق الغشاء الامنيوسي المبكر قبل حدوث الولادة كمجموعة حالات. 50 امرأة أخرى كانت من النساء الحوامل اللواتي لديهن عمر حمل متطابق مع غشاء سليم وليس لديها ولادة دون أي مضاعفات خلال الحمل كمجموعة ضابطه .وتم تقدير مستوى الفوليت ، بي 12 والهيموسستين من المصل .ثم تم جمع البيانات وتحليلها احصائيا. ان عوامل الخطورة ذو اهمية لتمزق الغشاء الامنيوسي المبكر قبل الولادة هي : النساء العاملات، والأميات، عدم وجود أو وجود اقل من ثلاثة زيارات لرعاية الحمل والولادة، الفاصل الزمني القصير بين الحمل ، وجود ولادة مبكرة سابقة أو تمزق الأغشية المبكر قبل الولادة ، المدخنات الثانويات ، نقص مستوى الفوليت ومستوى مرتفع من الهيموسيستين .فيما يتعلق بالبيانات الديموغرافية ومستوى فيتامين بي 12 لم يكن مختلفًا بين المجموعتين. من ناحية أخرى ، كان مستوى الفوليت أقل في مجموعة الحالات تمزق الأغشية المبكر قبل الولادة منه في المجموعه الضابطه. كان مستوى الهيموسيستين أعلى بشكل ملحوظ في مجموعة الحالات من المجموعة الضابطة . ارتبط مستوى الهيموسيستين ≥ 28.85 نانومول / مل بحساسية عالية وخصوصية ودقة (90 و 84 و 87٪ على التوالي) ، بالتالي يمكن استخدامه أيضًا كأداة جيدة لاستبعاد التنبؤ بالخطر لتمزق الأغشية المبكر قبل الولادة . بينما يرتبط مستوى الفوليت ≤3.22 نانوغرام / مل بحساسية معتدلة ونوعية منخفضة. نستنتج من ذلك ان مستوى الهيموسيستين ومستوى الفوليت هو علامة جيدة لتمزق الأغشية المبكر قبل الولادة، بالاضافة الى ارتقاع الهميوسيستين هو احد عوامل الخطورة لتمزق الاغشية المبكر قبل الولادة. مستوى فيتامين بي 12 لم يترافق مع زيادة خطر تمزق الأغشية المبكر قبل الولادة.

Obstetrics Outcome in Preterm Premature Rupture of Membrane

Preterm Premature Rupture of Membranes (PPROM) is defined as the spontaneous rupture of fetal membranes before 37 completed weeks of gestation and before the onset of labor. The incidence of PPROM is around 2-3% of all pregnancies, and it complicates about 3% of pregnancies, leading to 30%-40% of premature births. PPROM can result in significant morbidity and mortality, causing various complications such as sepsis, pulmonary hypoplasia, chorioamnionitis, and necessitating Neonatal Intensive Care Unit (NICU) admissions. This study aimed to investigate the perinatal and maternal outcomes in cases of PPROM. In this study, PPROM was observed in 47% of cases in the age group of 20-25 years. Among the patients admitted with PPROM, 70% were primigravida. Breech presentation was the most common risk factor, followed by previous pregnancy, polyhydramnios, urinary tract infection, and history of recent coitus. The most common organism identified was E. coli (11.76%). Maternal complications included puerperal pyrexia (23.53%), chorioamnionitis (17.65%), abruption placentae (5.88%), and wound infection (5.8%). Approximately 52% of the admitted babies experienced neonatal morbidity, with respiratory distress syndrome being the most prevalent (17%), followed by jaundice (11%), septicemia (5.88%), and intraventricular hemorrhage (IVH) (5.88%). Among the 85 cases studied, 10 neonatal deaths were recorded, accounting for 11% of the cases.

Fetomaternal Outcome of Preterm Premature Rupture of Membranes

Fetomaternal Outcome of Preterm Premature Rupture of Membranes

Two- and Three-Dimensional Ultrasonographic Evaluation of the Fetal Thymus in Women with Preterm PrematureRupture of Membranes: A Prospective Study

Objective: To evaluate the relationship between fetal thymus diameter and perinatal outcomes in preterm premature rupture of membranes (PPROM) cases and to compare three-dimensional (3D) fetal thymus volume in the same cases. Material and Methods: This was a prospective study from March 2019 through March 2020. Women diagnosed with PPROM between 24 and 33+6 weeks of gestation were included. Pregnancies were divided into 2 groups as small and normal according to the thymus size nomogram. The virtual organ computeraided analysis software calculated the volumes automatically. Results: In 41 patients, measurements could be successfully acquired with twodimensional and 3D sonography. Twenty eight (68.3%) patients were in the small thymus group and 13 patients (31.7%) were in the normal thymus group. The probability of clinical chorioamnionitis increased 7.7-fold-times in cases with small thymus (odds ratio 7.7, 95% confidence interval 1.1-67.4, p=0.038). The latency period was significantly higher in the normal thymus group. The correlation between transverse diameter and thymus volume was analyzed according to gestational age at ultrasound measurement and a significant correlation was observed between them. Conclusion: A small transverse diameter of the thymus in PPROM cases may be associated with clinical chorioamnionitis, and a normal thymus diameter may predict a longer latency period. In addition, although transverse thymus diameter was correlated with thymus volume, no significant volume difference was observed between the groups when percentile classification was made.

Maternal and fetal outcome in preterm premature rupture of membrane: A cross sectional study

Background: The present study was conducted for assessing the maternal and fetal outcome in preterm premature rupture of membrane.Materials & methods: A total of 100 pregnant subjects were enrolled in the present study. Only those subjects were enrolled who were diagnosed with preterm rupture of membrane (PROM). The outcome variables for this study were maternal and fetal outcomes, grouped as favorable and unfavorable (complications). All the results were recorded in Microsoft excel sheet and were analysed by using SPSS software.Results: About 19% of the women showed unfavorable maternal outcomes.79 percent of the subjects were of primigravida. Duration of PROM was less than 12 years in 68 percent of the patients. Out of 19 subjects with maternal complications, sepsis, wound infection and haemorrhage was seen in 10 percent, 5 percent and 4 percent of the patients respectively. Still birth was seen in 7 percent of the patients while need of NICU was seen in 21 percent of the cases.Conclusion: In conclusion, PPROM is associated with a prenatal morbidity and the key to reducing the adverse effects of PPROM is to make a prompt diagnosis, admission and start antibiotic coverage.

Maternal & Fetal Outcome of Preterm Premature Rupture of the Membranes in Secondary Level Hospital in Bangladesh

Background: Premature rupture of membrane (PROM) is linked to significant fetal and maternal morbidity and mortalities. The maternal and fetal outcomes in PROM are very important to decrease maternal and child mortality and for better management and prevention of complications. Objective: To find out maternal & fetal outcomes of preterm premature rupture of the membranes. Methods and Material: This is a cross-sectional observational study carried out in the Department of Obstetrics & Gynaecology, 250 Beded District Hospital, Chapainawabganj, Rajshahi, Bangladesh from January 2016 to July 2016. 50 pregnant women with preterm premature rupture of the membranes. Result: The majority of patients with preterm PROM (30%) belong to the age group 31-35 years. The mean age of the patients and SD were 26.4±6.58. 60% of respondents were multipara and 40% primipara. Most of the patients had irregular antenatal checkups (56%), 24% had regular antenatal checkups, and 20% had no antenatal checkups. Twenty percent of patients developed labor pain within 15 hours of rupture of membrane, 24% within 16-30 hours, 56% within 31-45 hours, 10% within 46-60 hours, and 12% without the onset of labour pain. 37 (74%) patients with preterm PROM had a normal vaginal delivery, and 13(26%) delivered by caesarian Section. Forty-three percent of patients delivered within 24 hours of the ruptured membrane, followed by 24% of patients within 24-48 hours, and 28% of patients within more than 48 hours. Among 50 patients, 12 (24.0%) had a previous history of abortion, 24 (48%) had H/O preterm delivery due to PROM, 2 (4.0%) had H/O MR, and 6 (12.0%) had H/O D & C. Among 50 respondents with PPORM 4 (8.0%) had diabetes mellitus, (12.0%) had HTN, 15 (2.0%) had urinary tract infection and 10 (20.0%) had lower genital tract infection. In this study, the total number of the alive baby was 42, and the stillborn baby was 2. Out of 42 alive babies, 18(42.86%) were affected by the consequence of preterm PROM and the birth process. Among 48 alive babies, 6(12.50%) developed birth asphyxia, 5(10.42%) developed jaundice, 3(6.25%) developed neonatal sepsis, and 4 (8.33%) developed respiratory distress syndrome. Maternal morbidity were chorioamnionitis 4(8%) puerperal sepsis 5(10%), postpartum endometritis 2(4%), abruptio placenta 1(2%) and wound infection 2(4%). Conclusion: The incidence of preterm PROM was more in multipara. The majority of the patients were from lower- and middle-class families. This study found some factors, e.g., Coitus, the recent history of abortion, M.R., D & C, and previous history of PROM. The study was done with a small population, but it introduces us to certain risk factors that can be prevented. Proper health education, patient motivation, improved health hygiene, and adequate maternity and childcare services are needed to reduce morbidity and mortality.

Pregnancy outcomes after preterm premature rupture of membranes: The Japan Environment and Children's Study.

To evaluate the pregnancy outcomes of preterm premature rupture of membranes (preterm PROM; PPROM) by gestational age. This cohort study analyzed data from the Japan Environment and Children's Study. Pregnancy outcomes were documented using descriptive statistics. Logistic regression was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of complications. Data were collected for 104 062 fetuses, and 99 776 were eligible for inclusion. The incidences of early (18-23 weeks) and late (24-36 weeks) PPROM were 0.1% (n=102) and 1.2% (n=1205), respectively. Of the 1307 cases, 66 (5.0%) resulted in miscarriage or stillbirth. Overall, 85.6% (1119/1307) resulted in preterm births, and 9.3% (122/1307) in term births. There was a higher incidence of oligohydramnios (OR 6.82, 95% CI 4.07, 11.4; OR 2.42, 95% CI 1.72, 3.40), intrauterine infection (OR 11.9, 95% CI 7.06, 19.9; OR 4.39, 95% CI 3.01, 6.41), cesarean delivery (OR 3.31, 95% CI 2.32, 4.71; OR 1.34, 95% CI 0.97, 1.85), placental abruption (OR 5.57, 95% CI 2.30, 13.5; OR 5.40, 95% CI 3.58, 8.14), and 5-min Apgar score <7 (OR 35.3, 95% CI 21.5, 57.9; OR 2.66, 95% CI 1.75, 4.05) for early and late, compared to no, PPROM, respectively. Miscarriage or stillbirth was higher in early (OR 5.84, 95% CI 3.72, 9.15) and lower in late (OR 0.21, 95% CI 0.06, 0.68) compared to those without PPROM. This study described the epidemiology of pregnancy outcomes of early (occurring at the limit of viability) and late PPROM.

Maternal and Neonatal Outcomes of Preterm Premature Rupture of Membranes (PPROM) with Amniotic Fluid Index More Or Less than 5 in a Tertiary Care Setting In Pakistan

Objective: To explore the morbidity and mortality associated with preterm pre-labour rupture of membranes in the presence of amniotic fluid index (AFI) greater than or less than 5 in a tertiary care setting in Rawalpindi, Pakistan.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Gynaecology &amp; Obstetrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2019 to Aug 2020.&#x0D; Methodology: Data was collected from the patients presenting to the Department of Gynecology and Obstetrics at Pak emirates Military Hospital in Rawalpindi, Pakistan. Maternal and child outcomes were compared with an amniotic fluid index of less than or more than five among the patients with preterm premature rupture of membranes.&#x0D; Results: 1562 deliveries took place in our department, among them 73 (4.67%) cases were diagnosed as PPROM. Caesarean deliveries and the development of chorio-amnionitis were observed statistically significantly more with an amniotic fluid index &lt;5 (p-value &lt;0.001). Neonatal complications such as sepsis, respiratory distress syndrome, hypoglycemia, jaundice and hypothermia were also significantly observed in the group with amniotic fluid index &lt;5 (p-value &lt;0.05). Neonatal mortality was also significantly higher in the group with an amniotic fluid index &lt;5 (p-value: 0.004).&#x0D; Conclusion: Preterm premature rupture of membranes was a relatively common finding among the patients managed at our labour unit. Such patients with an amniotic fluid index of less than five are at a high risk of maternal and fetal adverse outcomes.

Maternal and Perinatal Outcome of Preterm Premature Rupture of Membranes in Minia University Maternity Hospital. (A prospective observational study)

Maternal and Perinatal Outcome of Preterm Premature Rupture of Membranes in Minia University Maternity Hospital. (A prospective observational study)

Cesarean section and pregnancy outcomes of preterm premature rupture of membranes under different fertility policies in China

BackgroundThe aim of the present study was to compare the outcomes of pregnancies complicated by preterm premature rupture of membranes (PPROM) in China.MethodsThe present study was a single-center retrospective study of women admitted to Beijing Obstetrics and Gynecology Hospital in 2012, 2014, and 2017. Deliveries at <24 and >37 weeks, fatal deformities, stillbirths, and multiple pregnancies were excluded. Pregnancies were divided into 24–27+6, 28–33+6, and 34–36+6 weeks according to weeks of gestation in each year. In total, 1,178 pregnancies complicated by PPROM were analyzed in terms of incidence rate, risk factors, delivery mode, and neonatal outcomes.ResultsThe rate of PPROM was 3.11% in 2012, 2.35% in 2014, and 2.4% in 2017; the difference was significant (P<0.001). Age [odds ratio (OR): 1.046, P<0.001], intrauterine infection (OR: 2.087, P=0.007), and vaginitis (OR: 1.812, P=0.039) were risk factors for PPROM. In all 3 years, patients with PPROM tended to choose vaginal delivery rather than cesarean section (CS) delivery (68.9% in 2012, P<0.001; 76.5% in 2014, P<0.001; 69.3% in 2017, P<0.001), and the rate of vaginal deliveries in 2014 was higher than that in 2012 and 2017 (P=0.027). Indications for PPROM at 34–36+6 weeks varied significantly among the 3 years (P<0.001). No significant difference was found in body weight, body length, and Apgar score at 1, 5, and 10 min; however, there was a significant difference in Apgar score after 1 min at 28–33+6 weeks (P=0.012).ConclusionsThe incidence rate of PPROM at our single center varied between 2012, 2014, and 2017. Risk factors for pregnancies complicated by PPROM include age, intrauterine infection, and vaginitis. The rate of CS delivery varied, and breech/transverse presentation was the major indication for patients with PPROM at 34–36+6 weeks.

Prevalence, Risk Factors and Outcome of Preterm Premature Rupture of Membranes at the Bamenda Regional Hospital

Background: Preterm premature rupture of membranes (PPROM) is one of the most common complications of pregnancy. It is one of the leading identifiable cause of preterm deliveries, and an important cause of maternal and perinatal morbidity and mortality. The aim of this study was to determine the prevalence of PPROM, to identify its associated factors and to evaluate the early outcome (within 72 hrs after delivery) following PPROM at the Bamenda Regional Hospital (BRH). Methods: A cross-sectional study was conducted in March and April 2020. Three hundred and eighty-seven women who delivered at the labour room of the BRH were included in this study. Interviewer-administered questionnaires were used to obtain data. The cases of PPROM were women who had lost amniotic fluid continuously before hospitalisation and whose gestational age was between 28 weeks + 0 days and 36 weeks + 6 days. Descriptive statistics followed by logistic regression analyses were conducted with level of significance set at p-value Results: Among the 387 participants included in the study, 19 had PPROM giving a prevalence of 4.91%. Of 57 preterm deliveries, PPROM accounted for 33.33% (n = 19). The statistically significant independent factors associated with lower odds of PPROM were the age groups 20 - 29 years (aOR = 0.07, 95% CI: 0.01 - 0.42, p = 0.003) and ≥30 years (aOR = 0.01, 95% CI: 0.001 - 0.14, p = 0.001), and attending ANC ≥ 4 times (aOR = 0.23, 95% CI: 0.06 - 0.84, p = 0.026). Whereas, having a multiple pregnancy (aOR = 39.72, 95% CI: 7.19 - 219.33, p - 897.90, p - 112.56, p = 0.003), and having a history of preterm delivery (aOR = 27.65, 95% CI: 1.76 - 434.15, p = 0.018) were associated with a higher likelihood of PPROM. The study revealed that 10.53% (n = 2) of women who had PPROM had an unfavourable outcome. Babies born by mothers who had PPROM were more likely to have an unfavourable outcome (OR = 14.44, 95% CI: 5.42 - 38.48, p Conclusion: Preterm premature rupture of membranes considerably causes perinatal morbidity and mortality, and thus optimum obstetric and medical care is essential for the reduction of the complications related to it.

Perinatal Outcomes Associated with Latency in Late Preterm Premature Rupture of Membranes.

This study aims to evaluate the perinatal outcomes of preterm premature rupture of membrane (PPROM) with latency periods at 33 + 0–36 + 6 weeks of gestation. This retrospective case-control study included women with singleton pregnancies who delivered at 33 + 0–36 + 6 weeks at Korea University Ansan Hospital in South Korea between 2006–2019. The maternal and neonatal characteristics were compared between different latency periods (expectant delivery ≥72 h vs. immediate delivery <72 h). Data were compared among 345 women (expectant, n = 39; immediate delivery, n = 306). There was no significant difference in maternal and neonatal morbidities between the groups, despite the younger gestational age in the expectant delivery group. Stratified by gestational weeks, the 34-week infants showed a statistically significant lower exposure to antenatal steroids (73.4% vs. 20.0%, p < 0.001), while the incidence of respiratory distress syndrome (12.8%) and the use of any respiratory support (36.8%) was higher than those in the 33-week infants, without significance. Our study shows that a prolonged latency period (≥72 h) did not increase maternal and neonatal morbidities, and a considerable number of preterm infants immediately delivered at 34 weeks experienced respiratory complications. Expectant management and antenatal corticosteroids should be considered in late preterm infants with PPROM.

A cut-off value for systemic immune-inflammation index in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes.

To determine a cut-off value for systemic immune-inflammation index (SII)(neutrophil × platelet /lymphocyte) in the prediction of adverse neonatal outcomes in preterm premature rupture of the membranes (PPROM). This retrospective cohort study was conducted among singleton pregnancies with PPROM. Cases were divided into two main groups: Group 1) PPROM diagnosed at 24th-28th weeks of gestation and Group 2) PPROM diagnosed at >28th-34th weeks of gestation. Thereafter, main study groups were divided into two subgroups: Subgroup A: pregnancies with favorable neonatal outcomes and Subgroup B: pregnancies with composite adverse neonatal outcomes. Subgroups were compared in terms of demographic features, clinical characteristics, laboratory test results and SII values. Furthermore, cut-off values of SII for the prediction of composite adverse neonatal outcomes were determined for two main groups. A Mann-Whitney U test was conducted to compare the median values and the chi-square test was used to compare categorical variables among the groups. Receiver operating characteristic (ROC) curves were used to assess the performance of SII value in predicting composite adverse neonatal outcomes. Significant differences were observed for median platelet and SII values between the subgroups (P < 0.001 for both in group 1 and P = 0.002 and P = 0.005, respectively, in group 2). Cut-off values of 1695.14 109 /L (83.3% sensitivity, 85.7% specificity) and 1430.90 × 109 /L (71.4% sensitivity, 75.7% specificity) for composite adverse neonatal outcomes were determined, respectively in group 1 and 2 according to the ROC curve analysis. SII may be used as an additional indicator for the prediction of adverse neonatal outcomes in PPROM.

Fetal and Maternal Outcome in Preterm Premature Rupture of Membranes (PPROM) at Ain Shams Maternity Hospital: A Retrospective Analysis of Last Five Years Admissions

Abstract Background PPROM is defined as spontaneous rupture of the membranes before the onset of labour prior to 37 weeks gestation. It complicates 2-4% of all singletons and 7-20% of twin pregnancies and is associated with over 60% of preterm births. Aim of the Work to retrospectively compare the neonatal and maternal outcomes in women with preterm prelabor rupture of the membranes (PPROM) who delivered before versus who delivered after 34 weeks of gestation over a 5-year period (between January 2011 and December 2015). Patients and Methods This retrospective case-control study was conducted at Ain Shams University Maternity Hospital. The analysis covered the period between January 2011 and December 2015. The study included all women admitted to Ain Shams University Maternity Hospital during the period between January 2011 and December 2015 with a diagnosis of preterm prelabor rupture of the membranes (PPROM). Results The incidence of chorioamnionitis (p-value &amp;lt;0.001) and maternal sepsis (p-value = 0.001) were both significantly higher in those delivering before 34 weeks. The gestational age at ROM was significantly lower and the latent period was significantly shorter in patients delivering before 34 weeks of gestation (p-values &amp;lt;0.001). The Apgar score at 1 and 5 minutes as well as the birth weight were significantly lower in the group delivering before 34 weeks of gestation (p-values &amp;lt;0.001). The incidence of low Apgar score at 1 and 5 minutes (p-value &amp;lt;0.001 and 0.002, respectively), NEC (p-value = 0.006), IVH (p-value &amp;lt;0.001), RDS (p-value = 0.005) and neonatal death (p-value &amp;lt;0.001) were all significantly higher in patients delivering before 34 weeks of gestation. Conclusion In women with premature preterm rupture of membrane neonatal and maternal outcomes is better in those who delivered after 34 weeks of gestation when compared to those who delivered before 34 weeks of gestation.

Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation.

The aim of this study was to assess the maternal and neonatal outcome in patients with preterm prematurerupture of membranes between 22 to 37 weeks of gestation in comparison to preterm birth patients. Group of PPROM patients consisted of 127 women, the control group counted 141 women whodelivered prematurely. The control group was formed by matching patient with the same gestational age at deliveryand neonatal birth weight to every woman from study group. In both groups speculum and ultrasound examinationswere performed, microbiological swabs were taken. In unclear cases of PPROM tests detecting amniotic proteins, suchas PAMG-1 or IGFBP-1, were performed. According to gestational age at delivery, neonates were divided into subgroups:extremely premature infants (< 27 weeks 6 days), moderate premature infants (from 28 weeks 0 days to 33 weeks 6 days),late premature infants (from 34 weeks 0 days to 37 weeks 0 days). In the study group, median gestational age of delivery was 34 weeks 1 day and the same in control group - 34 weeksand 5 days (p > 0.05). Parameters of inflammatory status were more often reported in the PPROM group than in the pretermbirth group, even if they weren't statistically significant (positive culture of cervical swab, increased leukocytosis, CRP above 5).The rate of neonate survival was similar in both groups (93.7% and 94.1%). Congenital infection was more often diagnosed ingroup of neonates from PPROM pregnancies than in neonates from control group; (36% and 21.2% respectively; p = 0.009). Our research appears to be consistent with theory of inflammatory etiology of PPROM. Optimal managementof infection in PPROM patients seems to be the most important in efforts to prolong pregnancy.

Risk Factors and Outcomes of Preterm Premature Rupture of Membranes in a Cohort of 6968 Pregnant Women Prospectively Recruited.

We revisited risk factors and outcomes related to the preterm premature rupture of membranes (PPROM). A total of 7866 pregnant women were recruited during 5 years at their first prenatal visit to the perinatal clinic of the institution. We compared three groups (women without prematurity, women with spontaneous preterm labor with intact membranes (sPL with IM), women with PPROM) regarding 60 criteria about characteristics, lifestyle, medical, gynecological, obstetrical history of mothers, medication during pregnancy, events at delivery, and complications in neonates. Logistic regression analyses adjusting for potential confounding factors were used. Of the 6968 women selected, 189 (2.8%) presented a PPROM, and 225 (3.2%) an sPL with IM. The specific risk factors for PPROM were body mass index (BMI) <18.5 kg/m2 (adjusted odds ratio, aOR: 2.00 (1.09–3.67)), history of PPROM (aOR: 2.75 (1.19–6.36)), nulliparity (aOR: 2.52 (1.77–3.60)), gestational diabetes (aOR: 1.87 (1.16–2.99)), and low level of education (aOR: 2.39 (1.20–4.78)). The complications associated with PPROM were abruption placentae, cesarean, APGAR 5′ <4, birth weight <2500 g, stillbirth, neonatal jaundice, and hospitalization of mother and neonates. All these complications were also associated with sPL with IM. Our study confirms some of the risk factors of PPROM and highlights a new one: gestational diabetes. Outcomes of PPROM are related to prematurity.

A study on Maternal and fetal outcomes of preterm premature rupture of membrane in Tertiary Medical College Bangladesh

A study on Maternal and fetal outcomes of preterm premature rupture of membrane in Tertiary Medical College Bangladesh

The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes.

Objective A 7-day course of a penicillin (PCN) and macrolide is standard of care (SAR) in preterm premature rupture of membranes (PPROM). Data regarding alternative antibiotic regimens are limited. We sought to assess the impact of non-PCN regimens on neonatal outcomes. Study Design Secondary analysis of randomized controlled trial of antenatal magnesium sulfate. Singleton, nonanomalous pregnancies complicated by PPROM at > 24 weeks of gestation receiving the SAR were compared with women receiving a non- β -lactam regimen and a macrolide (NPCR). Primary outcome was a neonatal composite. Secondary outcomes included pregnancy latency, endometritis, and chorioamnionitis. Results A total of 949 women met inclusion criteria; 821(56%) received the SAR and 128(8.8%) received NPCR. Adjusted models did not demonstrate worse outcomes (AOR [adjusted odds ratio] = 0.50; 95% CI [confidence interval]: 0.22–1.11). Neonates receiving SAR were less likely to have bronchopulmonary dysplasia (BPD; p = 0.03) but more likely to have severe necrotizing enterocolitis (sNEC; p = 0.04). Risk for chorioamnionitis and median latency did not differ between groups but women receiving the SAR were less likely to get endometritis (AOR = 0.35; 95% CI: 0.14–0.91). Conclusions In this cohort, receiving NPCR in the setting of PPROM did not impact the overall risk of adverse neonatal outcomes or latency, but did increase the risk of endometritis. Alterations in individual neonatal morbidities suggest follow-up studies are needed.

526: Effect of meconium stained amniotic fluid on perinatal outcome in preterm premature rupture of membranes

526: Effect of meconium stained amniotic fluid on perinatal outcome in preterm premature rupture of membranes