Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes

Ramsey, Patrick S.; Lieman, Joelle M.; Brumfield, Cynthia G.; Carlo, Waldemar A.

doi:10.1016/j.ajog.2004.11.035

Cited by 165 publications

(104 citation statements)

References 21 publications

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“…Studies report an association between PPROM and oligohydramnios and adverse perinatal outcomes, 3,5,6 similar to this study which observed an association mainly with severe oligohydramnios. Perinatal mortality was high (18.6%), double that found in a university hospital in Iran, which described a rate of 8.7%, 8 but lower than the 25.7% observed in a university hospital in the southeast of Brazil.…”

Section: Discussionsupporting

confidence: 89%

“…A percentage of 36% for chorioamnionitis was considered in pregnant women with oligohydramnios after PPROM, and 9% in pregnant women without oligohydramnios. 5 For a strength of 80% and a 95% confidence level, we found that the sample of our study of 86 pregnant women would be sufficient to provide us with an answer.…”

Section: Methodsmentioning

confidence: 81%

“…Nevertheless, we must remember that cesarean sections can increase the risk of maternal infection and its complications, particularly in women at risk of developing chorioamnionitis. 5,7,12 Thus, given the rigorous monitoring of these patients it is likely that the rate of perinatal mortality was due to neonatal sepsis and not compression of the umbilical cord. Another point in favor of mortality, as a result of sepsis, is that the risk of neonatal sepsis was equal to the risk of early neonatal death.…”

Section: Discussionmentioning

confidence: 99%

“…3 However, it can be said that AFI is a good indicator of fetal prognosis in the presence of PPROM. 5 …”

Section: Discussionmentioning

confidence: 99%

“…3 In addition to the presence of chorioamnionitis, the long length of time of premature rupture of membranes and the oligohydramnios are risk factors for adverse perinatal outcomes. [5][6][7][8] PPROM is one of the main causes of prematurity and its complications, such as newborn respiratory distress syndrome, neonatal sepsis, necrotizing enterocolitis, intraventricular hemorrhage, periventricular leukomalacia, varying degrees of hypoplasia and bronchopulmonary dysplasia, contributing greatly to an increase in neonatal morbidity and mortality. 7,8 A prospective cohort study in women with PPROM verified the association of oligohydramnios, the lowest latency period, and increase in adverse perinatal outcomes, such as an Apgar score lower than seven at five minutes after birth and increased rate of neonatal deaths, 8 unlike a different study.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Souza

Patriota

Guerra

et al. 2016

Rev. Assoc. Med. Bras.

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Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher's exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion:The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

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Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

“…3 However, it can be said that AFI is a good indicator of fetal prognosis in the presence of PPROM. 5 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Souza

Patriota

Guerra

et al. 2016

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

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Factors associated with neonatal outcomes in preterm prelabor rupture of membranes after cervical cerclage

Chen

Sun

et al. 2019

Intl J Gynecology & Obste

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Objective To evaluate risk factors associated with neonatal morbidity and mortality in pregnant women with preterm prelabor rupture of membranes (PPROM) after cervical cerclage. Methods A retrospective cohort study of singleton pregnancies with cervical insufficiency was conducted at a tertiary referral center in Taiwan from May 1, 2000 to July 31, 2017. Patients with PPROM after cerclage and delivered between 20 0/7 days and 36 6/7 days were recruited. Logistic and linear regression analyses were performed to evaluate various risk factors. Results Overall, 109 women were included. Mothers with a higher white blood cell count, a higher C‐reactive protein (CRP) level, a lower amniotic fluid index, and chorioamnionitis were significantly associated with neonatal morbidity. Neonatal mortality was related to oligohydramnios (adjusted odds ratio [aOR] 2.98, 95% confidence interval [CI] 1.11–8.01) and chorioamnionitis (aOR 3.17, 95% CI 1.03–9.69). An elevated CRP level was associated with a shorter PPROM to delivery latency (adjusted B −16.64, 95% CI −29.88 to −3.41), but cerclage retention more than 12 hours after PPROM was associated with a prolonged latency (adjusted B 17.21, 95% CI 3.25–31.18). Conclusion Oligohydramnios and chorioamnionitis are associated with neonatal mortality.

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Multi‐modal MRI reveals changes in placental function following preterm premature rupture of membranes

Hutter

Slator

Zampieri

et al. 2022

Magnetic Resonance in Med

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Purpose: Preterm premature rupture of membranes complicates up to 40% of premature deliveries. Fetal infection may occur in the absence of maternal symptoms, delaying diagnosis and increasing morbidity and mortality. A noninvasive antenatal assessment of early signs of placental inflammation is therefore urgently required.Methods: Sixteen women with preterm premature rupture of membranes < 34 weeks gestation and 60 women with uncomplicated pregnancies were prospectively recruited. A modified diffusion-weighted spin-echo single shot EPI sequence with a diffusion preparation acquiring 264 unique parameter combinations in < 9 min was obtained on a clinical 3 Tesla MRI scanner. The data was fitted to a 2-compartment T * 2 -intravoxel incoherent motion model comprising fast and slowly circulating fluid pools to obtain quantitative information on perfusion, density, and tissue composition. Z values were calculated, and correlation with time from between the rupture of membranes and the scan, gestational age at delivery, and time between scan and delivery assessed. Results: Placental T *2 was significantly reduced in preterm premature rupture of membranes, and the 2-compartmental model demonstrated that this decline is mainly linked to the perfusion component observed in the placental parenchyma. Multi-modal MRI measurement of placental function is linked to gestational age at delivery and time from membrane rupture. Conclusion:More complex models and data acquisition can potentially improve fitting of the underlying etiology of preterm birth compared with individual single-contrast models and contribute to additional insights in the future. This will need validation in larger cohorts. A multi-modal MRI acquisition between rupture of the membranes and delivery can be used to measure placental function and is linked to gestational age at delivery.

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Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes

Cited by 165 publications

References 21 publications

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Factors associated with neonatal outcomes in preterm prelabor rupture of membranes after cervical cerclage

Multi‐modal MRI reveals changes in placental function following preterm premature rupture of membranes

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