International Multicentre Term Prelabor Rupture of Membranes Study: Evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term

Seaward, P. G. R.; Hannah, Mary E.; Myhr, Terri L.; Farine, Dan; Ohlsson, Arne; Wang, Elaine E.; Haque, Khalid N.; Weston, Julie; Hewson, Sheila; Ohel, Gonen; Hodnett, Ellen

doi:10.1016/s0002-9378(97)70007-3

Cited by 146 publications

(111 citation statements)

References 18 publications

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“…The risk of chorioamnionitis with term PROM has been reported to be less than 10% and to increase to 40% after 24 hours of PROM. 4 The risk of intrauterine infection increases with duration of labour. Evidence supports the idea that induction of labour, as opposed to expectant management, decreases the risk of chorioamnionitis without increasing the caesarean delivery rate.…”

Section: Introductionmentioning

confidence: 99%

“…The risk of chorioamnionitis with term PROM has been reported to be less than 10% and to increase to 40% after 24 hours of PROM. 4 The risk of intrauterine infection increases with duration of labour. Evidence supports the idea that ABSTRACT Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection.…”

mentioning

confidence: 99%

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A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

Sinha

Gupta

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONIn approximately 8 to 10% of pregnancies the membranes ruptures before the onset of labour. Premature rupture of membrane (PROM) is defined as spontaneous rupture of membranes anytime beyond 28 th week of pregnancy but before the onset of labour. When membrane rupture occurs beyond 37 weeks but before term, it is called Term PROM and when it occurs before 37 completed weeks it called preterm PROM.1 The short term risks of PROM include cord prolapse, cord compression and placental abruption. Whereas the long term risks include maternal infection (such as chorioamnionitis, postpartum endometritis, and sepsis) and more seriously, neonatal infection. 2Spontaneous labour follows term PROM at 24, 48, and 96 hours in 70%, 85% and 95% of women, respectively. Thus, an important proportion of women have significant latency from PROM to delivery if managed expectantly, particularly in nulliparous women. 3 The risk of intrauterine infection increases with the duration of PROM. The risk of chorioamnionitis with term PROM has been reported to be less than 10% and to increase to 40% after 24 hours of PROM. 4 The risk of intrauterine infection increases with duration of labour. Evidence supports the idea that ABSTRACT Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients. Methods: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection. This randomized comparative study has been done to compare the effectiveness and safety of low and high dosage (25 mcg and 50mcg) regimen of vaginal misoprostol for induction in term PROM patients. Results: PROM to delivery interval was significantly shorter with 50mcg vaginal misoprostol as compared to 25 mcg vaginal misoprostol (15.71±3.29 hours vs. 18.23±3.23 hours, (p value = 0.0023) Number of doses required was less with 50mcg vaginal misoprostol group as compared to 25mcg vaginal misoprostol (1.22±0.42 vs. 1.91±0.80, p value <0.05). 83.6% women in group A and 69.09% women in group B underwent spontaneous vaginal delivery within 24 hours. 3.64% women in group A and 7.27% in group B had instrumental delivery. Caesarean section was performed in 12.27% cases in group A and 23.64% cases in group B. The complication rate was comparable. Conclusions: 50mcg vaginal misoprostol is more effective and safe for induction of labour at term PROM as compared to 25 mcg vaginal misoprostol

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Section: Introductionmentioning

confidence: 99%

“…The risk of chorioamnionitis with term PROM has been reported to be less than 10% and to increase to 40% after 24 hours of PROM. 4 The risk of intrauterine infection increases with duration of labour. Evidence supports the idea that ABSTRACT Background: At term, infection remains the most serious complication associated with PROM for the mother and the neonate Induction of labour significantly reduces the risk of maternal and foetal infection.…”

mentioning

confidence: 99%

A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

Sinha

Gupta

2017

Int J Reprod Contracept Obstet Gynecol

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“…For singletons at term, the International Multicentre Term PROM Study Group (Seaward et al, 1997;Seaward et al, 1998b) identified independent predictors of chorioamnionitis, postpartum fever, and neonatal infection (Table 1). PPROM in twin pregnancies has been associated with both shorter (Bianco et al, 1996) and the same (Hsieh et al, 1999) PPROM to labour latency than in singleton pregnancies, but similar perinatal outcomes (Bianco et al, 1996;Seaward et al, 1998b).…”

Section: Introductionmentioning

confidence: 99%

The Association Between Early Membrane Rupture, Latency, Clinical Chorioamnionitis, Neonatal Infection, and Adverse Perinatal Outcomes in Twin Pregnancies Complicated by Preterm Prelabour Rupture of Membranes

Dadelszen¹,

Kives²,

Delisle³

et al. 2003

Twin res.

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T he objective of this study was to evaluate associations between adverse outcomes in twin pregnancies and preterm prelabour rupture of membranes (PPROM). A chart review of 246 consecutive twin pregnancies with confirmed PPROM was conducted. Regression analysis (β [natural log of the odds ratio] and odds ratio [OR]) was performed to identify independent predictors. Two hundred and forty-six twin pregnancies, 492 liveborns, and 20 neonatal deaths. Mean (SD) PPROM gestational age (GA): 31.3 (3.8) wk; delivery GA: 32.0 (3.3) wk. PPROM < 30wk was associated with increased parity (OR: 2.66), and log (admission leukocyte count) (OR: 9.99). Shortened latency was associated with PPROM GA (β = -0.17) and chorioamnionitis (β = 0.95). Neonatal sepsis was predicted by lower delivery GA (OR: 2.04). Adverse perinatal outcomes were protected against by older GA at PPROM (OR 0.53) and shortened latency (OR 0.73). It was concluded that increased leukocytosis and parity implies an infectious aetiology in earlier PPROM. Increased risk for neonatal sepsis at earlier delivery GA is consistent with gestation-dependent fetal immunocompetence. Early PPROM and long latencies were associated with increased adverse perinatal outcomes. BackgroundPreterm prelabour rupture of membranes (PPROM) complicates 2-4% of singleton pregnancies (Duff, 1996), and 3-7% of twin pregnancies (Kovacs et al., 1989;Sassoon et al., 1990b). Specific concerns attach themselves to PPROM in multiple pregnancies, as these pregnancies are predisposed to premature delivery (Skupski & Chevernak, 1996), and, increasingly frequent, result from assisted reproduction technologies following a period of subfertility (Gall, 1996;von Dadelszen et al., 1999). Both multiple pregnancy and PPROM are independent predictors of neonatal intensive care admission, with multiple pregnancy alone contributing 19% of all neonatal intensive care unit days (Ross et al., 1999). In addition, the presence of an intact sac with a normal amniotic fluid volume for fetal growth and development, but at risk for infection, provides the clinician with a series of clinical (Lewis & Mercer, 1996), sometimes ethical (De Catten et al., 1998), challenges.For singletons at term, the International Multicentre Term PROM Study Group (Seaward et al., 1997;Seaward et al., 1998b) identified independent predictors of chorioamnionitis, postpartum fever, and neonatal infection (Table 1). PPROM in twin pregnancies has been associated with both shorter (Bianco et al., 1996) and the same (Hsieh et al., 1999) PPROM to labour latency than in singleton pregnancies, but similar perinatal outcomes (Bianco et al., 1996;Seaward et al., 1998b).This retrospective study was performed to identify the important associations between membrane rupture before 34 weeks' gestation, the latent interval between PPROM and labour onset, clinical chorioamnionitis, neonatal sepsis, and adverse perinatal outcomes in twin pregnancies complicated by PPROM. Although PPROM is known to increase the risk of infectious morbidity, not all patients wi...

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“…Secondary analysis showed association between longer time periods from membrane rupture to delivery and a higher incidence of neonatal infection. Secondary analysis of data from the International Multicentre Term Prelabour Rupture of Membranes Study found duration of active labour to be the strongest independent predictor of clinical chorioamnionitis [21].…”

mentioning

confidence: 98%

“…The UK does not have a GBS screening program. Up to a third of women have vaginal colonisation, which is an independent predictor for chorioamnionitis [21], and their babies are at a 25 fold higher risk of early onset GBS sepsis [4]. By the time women deliver, PROM may have exceeded the 18 h stated in the Royal College of Obstetricians and Gynaecologists (RCOG) guideline as a risk factor for early onset neonatal GBS sepsis (2.0-8.7 fold increased risk) [17].…”

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confidence: 99%

Management of prelabour rupture of membranes (PROM) at term

Ismail

Lahiri

2013

Journal of Perinatal Medicine

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Over a 20-month period we identified several cases of neonatal pneumonia associated with prelabour rupture of membranes (PROM) at term. PROM complicates 8%-10% of all pregnancies, yet 60% of cases occur at term. Ascending infection is a contributing factor and the incidence of chorioamnionitis in these patients is relatively high, especially with prolonged membrane rupture. The signs and symptoms NICE recommends patients look out for are not always present as the majority of infections are subclinical, yet associated maternal and neonatal morbidity of chorioamnionitis is potentially devastating. A survey of maternity units in the West Midlands reveals significant variance in management of these cases. Given the lack of consensus and clear evidence on optimal management of PROM at term, we believe early detection of developing infections could be enhanced by using a combination of investigations (at presentation, 12 and 24 h), as well as current advice to self-monitor temperature and vaginal loss.

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International Multicentre Term Prelabor Rupture of Membranes Study: Evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term

Cited by 146 publications

References 18 publications

A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

A comparative study of 25µg versus 50µg vaginal misoprostol for induction of labour at term premature rupture of membrane

The Association Between Early Membrane Rupture, Latency, Clinical Chorioamnionitis, Neonatal Infection, and Adverse Perinatal Outcomes in Twin Pregnancies Complicated by Preterm Prelabour Rupture of Membranes

Management of prelabour rupture of membranes (PROM) at term

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