Premature Rapture Of Membranes Research Articles

Factors associated with low birth weight among neonates born at Olkalou District Hospital, Central Region, Kenya.

IntroductionNinety-two percent of Low Birth Weight(LBW) infants are born in developing countries, 70% in Asia and 22% in Africa. WHO and UNICEF estimate LBW in Kenya as11% and 6%by 2009 Kenya Demographic Health Survey. The same survey estimated LBW to be 5.5% in Central Province, Kenya. Data in Olkalou hospital indicated that prevalence of LBW was high. However, factors giving rise to the problem remained unknown.MethodsA cross-sectional analytic study was therefore conducted to estimate prevalence and distribution and determine the factors associated with LBW in the hospital. LBW was defined as birth of a live infant less than 2500g. We collected data using a semi-structured questionnaire and review of health records. A total 327 women were randomly selected from 500mothers. Data was managed using Epi Info 3.3.2.ResultsThe prevalence of LBW was 12.3% (n=40). The mean age of mothers was 25.6±6.2 years. Mean birth weight was 2928±533 grams. There were 51.1% (n=165) male neonates and 48.9% (n=158) females. The following factors were significantly associated with LBW:LBW delivery in a previous birth (OR=4.7, 95%C.I.=1.53-14.24), premature rapture of membranes (OR=2.95, 95%C.I.=1.14-7.62), premature births (OR=3.65, 95%C.I.=1.31-10.38), and female newborn (OR=2.32, 95%C.I.=1.15-4.70). On logistic regression only delivery of LBW baby in a previous birth (OR=5.07, 95%C.I.=1.59-16.21) and female infant (OR=3.37, 95%C.I.=1.14-10.00)were independently associated with LBW.ConclusionPrevalence of LBW in the hospital was higher than national estimates. Female infant and LBW baby in a previous birth are independent factors. Local prevention efforts are necessary to mitigate the problem. Population-based study is necessary to provide accurate estimates in the area.

Maternal complications of twin deliveries in Jimma University Specialized Hospital, Southwest Ethiopia: A facility-based cohort study

Twin pregnancy is assumed to increase the risk of maternal and neonatal complications. This situation is worse in Sub-Saharan Africa because of lack of well-equipped facilities. Studies on twin pregnancy and maternal complications are limited in Ethiopia. Thus, this study aimed to fill this gap. A hospital-based cohort study was conducted in Jimma University Specialized Hospital on 144 twin deliveries and 288 singleton deliveries. Data were collected through face-to-face interview by using structured-questionnaire and analysed by SPSS V.20.0. The relative risks of twin deliveries were significantly higher for the occurrence of hypertension, preterm labor, poor progress of labor, premature rapture of membrane, polyhydramnos, cord prolapse, uterine atony, postpartum haemorrhage, puerperal sepsis and maternal death as compared with singleton deliveries. In conclusion, women with twin pregnancy were at a higher risk of medical and obstetric complications during antepartum, intrapartum and postpartum periods. Thus, special emphasis should be given to mothers with twin pregnancies during antenatal care, delivery and postnatal care so as to prevent or manage the complications early.

Prevalence of Failed Induction of Labor and Associated Factors Among Women Delivered in Hawassa Public Health Facilities, Ethiopia, 2015

Background: Induction of labor is an increasingly being done obstetric procedure throughout the world. It is carried out in approximately 20% of all pregnancies. It is associated with poorer outcomes when compared with spontaneous labor. Method: Institutional based cross sectional study was made on medical records of 294 women admitted for induction of labor in Hawassa public health facilities from 1st Jan, to 31st Dec, 2014. Systematic sampling technique was used to select samples. Data was collected by structured questionnaire and edited, then entered into Epi-Data version 3.1. Data was analyzed with Statistical Package for Social Science, version 21. First percentage, frequency and mean were calculated. Then, multivariable logistic regression analysis was done to evaluate the possible association of all variables that were candidate after binary logistic regression analysis. P-value of less than 0.05 in multivariable logistic regression was considered as statistically significant. Finally the result is summarized and presented in texts and charts. Result: The prevalence of failed induction of labor was 17.3%. Multivariable logistic regression analysis showed that advanced maternal age [AOR 9.21 (2.70-31.35)], Nulliparity [AOR 3.11 (1.01-9.62)], poor Bishop Score [AOR 4.54 (1.56-13.19)], greater for gestation [AOR 6.57 (2.18-19.72)], bad obstetric history [AOR 5.60 (1.35-23.29)], post term [AOR=4.52 (1.20-17.00)] and premature rapture of membrane [AOR 5.66 (1.96-16.32)] were significantly associated with failed induction of labor. Conclusion: Advanced age, Primiparity, unfavorable bishop score, premature rupture of membrane, greater for gestation and bad obstetric history had positive association with failed induction of labor. Developing practice guidelines may help to prevent unwarranted case selection and help to reduce the current high failure rates.

Upper Respiratory Tract Infection during Pregnancy: Is It Associated with Adverse Perinatal Outcome?

We sought to determine whether there is an association between upper respiratory tract infection (URTI) requiring hospitalization during pregnancy and adverse perinatal complications. A retrospective population-based study comparing all singleton pregnancies of patients with and without URTI requiring hospitalization was performed. Multiple logistic regression models were performed to control for confounders. Data were collected from the computerized perinatal database. Out of 186,373 deliveries, 0.13% ( N = 246) required hospitalization due to URTI during pregnancy. URTI was significantly associated with preterm deliveries (PTD; 15.9% versus 7.9%; P < 0.001), lower birth weight (3082 +/- 624 versus 3183 +/- 546 g; P < 0.001), and higher rate of cesarean deliveries (CD; 20.3% versus 13.2%; P < 0.001) as compared with the comparison group. Even after controlling for possible confounders using multivariable analyses, the significant association between URTI and PTD (weighted odds ratio [OR] = 2.2; 95% confidence interval [CI] 1.6 to 3.1; P < 0.001) and CD (weighted OR = 1.5; 95% CI 1.1 to 2.2; P = 0.020) persisted. In contrast, no significant association was documented between URTI and premature rapture of membranes (4.9% versus 6.9%; P = 0.212), low Apgar scores (< 7) at 5 minutes (0.4% versus 0.6%; P = 0.761), and perinatal mortality (0 to 4% versus 1.3%; P = 0.223). Maternal URTI requiring hospitalization is an independent risk factor for PTD and CD.

628: Upper respiratory tract infection during pregnancy: is it associated with adverse perinatal outcome?

To determine whether there is an association between upper respiratory tract infection (URTI) requiring hospitalization during pregnancy, and adverse perinatal complications. A retrospective population-based study comparing all singleton pregnancies of patients with and without URTI requiring hospitalization was performed. Multiple logistic regression models were performed to control for confounders. Out of 186, 373 deliveries, 0.13% (n=246) required hospitalization due to URTI during pregnancy. URTI was significantly associated with preterm deliveries (15.9% vs. 7.9%; p<0.001), lower birth weight (3082±624 vs. 3183±546 grams; p<0.001) and higher rate of cesarean deliveries (CD; 20.3% vs. 13.2%; p<0.001) as compared to the comparison group. Even after controlling for possible confounders such as maternal age and parity, using multivariable analyses, the significant association between URTI and preterm delivery (weighted OR=2.2; 95% CI 1.6-3.1; p<0.001), as well as CD (weighted OR=1.5; 95% CI 1.1-2.2; p=0.020) persisted. In contrast, no significant association was documented between URTI and premature rapture of membranes (PROM; 4.9% vs.6.9%; p=0.212), low Apgar scores (<7) at 5 minutes (0.4% vs.0.6%; p=0.761) and perinatal mortality (0-4% vs.1.3 %; p=0.223). Maternal URTI is an independent risk factor for preterm delivery and cesarean delivery.

A clinical analysis of 181 cases of premature rupture of membranes

Objective This essay intends to explore into the inducing causes, treatment and pregnancy outcome of premature rupture of membranes.Methods It is a retrospective analysis of 181 cases. Results It has been found out that there were inducing factors for 76.8% premature rupture of membranes. Comparing the delivering ways of the gestational weeks of 28 to 34+6 weeks' with the 35 to 36+6 weeks' there was no sign difference between them (P> 0.05). Comparing the rate of asphyxia neonatorum of the gestational weeks of 28 to 34+6 weeks' and 35 to 36+6 weeks' s there was no sign difference between them(P< 0.01).Conclusions It can be concluded that in order to lower the rate of complicating diseases and improve the survival probability of newborn babies,it is necessary to take positive precautions against premature rupture of membranes and provide different treatment to the disease in different gestational weeks. Key words: Premature rapture of membrane; Premature labor; Pregnancy outcome

Chorioamnionitis does not affect fetal urine production in patients with premature rupture of membranes.

The objective of this study was to evaluate fetal urine production rate in patients with premature rupture of membranes in the presence or absence of chorioamnionitis and to determine its clinical usefulness. Fetal urine production was evaluated in 30 women between 24 and 39 weeks' gestational age with ruptured membranes. Fetal bladder measurements were determined every 3-5 min for 30-90 min. Chorioamnionitis was defined by both clinical criteria and histological examination of the placenta. The last determination of fetal urine production rate prior to delivery was compared in patients with and without histologic and/or clinical chorioamnionitis. Fetal urine production rate was corrected for gestational age using birth weight prior to analysis. A total of 96 assessments of fetal urine production were performed (range 1-16 per patient). Twelve subjects (40%) had no evidence of chorioamnionitis (group 1), 10 (33%) had histologic chorioamnionitis alone (group 2), and eight (27%) had both clinical and histologic chorioamnionitis (group 3). The mean (+/- SD) urine production rates in these groups were 9.43 +/- 3.15 ml/kg/hr, 10.65 +/- 3.43 ml/kg/hr, and 9.97 +/- 2.81 ml/kg/hr, respectively. The difference in fetal urine production rate between the three groups was not statistically significant. A power analysis revealed that individual group sizes were adequate to document a 50% increase in fetal urine production rate with a type II error of < 10%. There were no documented cases of fetal infection based on neonatal cultures. The presence of histologic or clinical chorioamnionitis does not significantly affect fetal urine production in patients with premature rupture of membranes. The prospective assessment of fetal urine production rate does not appear to be clinically useful as an early indicator of chorioamnionitis.

Amnioinfusion with Preterm, Premature Rupture of Membranes

Excluding labor, the greatest risks to the fetus from preterm PROM are umbilical cord accidents and infection. Heretofore, the clinical options for the PROM patient have been limited. With the advent and refinement of amnioinfusion, the utility of expectant management may be greatly increased. Through the use of amnioinfusion or its permutations, a number of diagnostic and therapeutic procedures previously unavailable to the PROM patient may become routine, including amniotic fluid volume expansion and direct in utero prophylaxis/treatment of amnionitis.