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

Choi, Eui Kyung; Kim, So Yeon; Heo, Ji-Man; Park, Kyu Hee; Kim, Ho Yeon; Choi, Byung Min; Kim, Hai-Joong

doi:10.3390/ijerph18020672

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…Most of these complications occurred after 2 weeks from ROM. Our results are supported by a study done by Choi et al (28) in which the chorioamnionitis was diagnosed in (17.9%) in the expectant group versus (4.3%) in the immediate delivery group in women with PPROM after 34 weeks of gestation. Those results were consistent with a metaanalysis concluding that expectant management improved maternal and infant outcomes in late preterm PROM, specifically relating to maternal infection (10) .…”

Section: Discussionsupporting

confidence: 90%

Perinatal Outcomes of Pregnancies with Preterm Premature Rupture of Membranes after 34 Weeks of Gestation

Nossair

El-Sayed²,

El-Shabrawy³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Preterm premature rupture of the membranes (PPROM) is an important contributor to perinatal mortality and morbidity. Neonatal complications are related primarily to the gestational age at rupture of membranes. Objective:The aim of the present study was to improve the perinatal maternal and fetal/neonatal outcomes in cases with preterm premature rupture of membranes between 34 -37 weeks of gestations. Patients and methods: This prospective case control study included 82 women comprised 41 with PPROM (group I) and 41 without ROM as matched controls (group II). All women were presented to maternity unit of Obstetrics and Gynecology Department over 8 months period, at Zagazig University Hospitals. Results: In this study (73.2%) with PPROM were below the age of 30 years. Urinary tract infection was 17.1% versus 12.2 %, cervicitis 4.9% versus 0% in patients with PPROM versus controls respectively. Maternal outcome in this study was evaluated; there were 82.9% of patients with PPROM versus 95.1% discharged from hospital within 4 days after delivery with no bad outcomes. Good Apgar score was (68.3%) in patients with PPROM and 82.9% in control group. In PPROM group; 7 fetuses were diagnosed as fetal distress and only 2 (4.9%) cases had clinical chorioamnionitis. Regarding neonatal morbidity in patients with PPROM, the results showed that respiratory distress syndrome (RDS) was diagnosed in 4 neonates, 7 with tachypnea, 6 with jaundice, and 3 with sepsis and no case of perinatal mortality. Conclusion:With appropriate care, the maternal risks of expectant management after 34 weeks of gestation are generally accepted to be minimal and a clear neonatal advantage exists by reducing risks of neonatal respiratory problems, admission for neonatal intensive care, and cesarean section.

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Section: Discussionsupporting

confidence: 90%

Perinatal Outcomes of Pregnancies with Preterm Premature Rupture of Membranes after 34 Weeks of Gestation

Nossair

El-Sayed²,

El-Shabrawy³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…We found that prolonged latency was unrelated to perinatal outcomes, Unlike chorioamnionitis, neonatal sepsis was not related to the duration of latency; this finding has also been confirmed by several other studies (27)(28)(29). Two studies revealed that a prolonged latency period was associated with a decreased incidence of neonatal mortality or morbidity (13,29).…”

Section: Discussionsupporting

confidence: 85%

Clinical Factors and Perinatal Outcomes Associated With Short Latency Period in Twin Pregnancies With Preterm Premature Rupture of Membranes Before 34 Weeks: A Retrospective Study

et al. 2022

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BackgroundThere is a lack of literature on short latency period (SLP) in twin pregnancies with preterm premature rupture of membranes (PPROM). Thus, the aim of this study was to identify the clinical factors and perinatal outcomes associated with SLP in twin pregnancies with PPROM and to establish a predictive model to identify SLP.MethodsTwin pregnancies with PPROM between 24 0/7 and 33 6/7 weeks were included and a retrospective analysis was performed. Patients were divided into two groups based on the latency period after PPROM: Group 1 ≤24 h (defined as SLP) and Group 2 >24 h (defined as long latency period, LLP), the clinical factors and perinatal outcomes were compared between the two groups. Binary logistic regression and receiver operating characteristic curve analyses were used to identify the independent clinical factors associated with latency period after PPROM and assess the predictive accuracy for SLP.Results98 and 92 pregnant women had short and long latency period, respectively. Prolonged latency significantly increased the occurrence of chorioamnionitis. Neonatal outcomes were not affected by latency duration after PPROM. Binary regression analysis revealed that higher gestational age (GA) at PPROM (P = 0.038), presence of uterine contractions (P < 0.001), Bishop score > 4 (P = 0.030), serum procalcitonin levels ≥0.05 ng/mL upon admission, and absence of use of tocolytic agents (P < 0.001) were significant independent predictors of a SLP. A predictive model developed using these predictors had an area under the curve (AUC) of 0.838, and the presence of uterine contractions alone had an AUC of = 0.711.ConclusionUterine contraction was the most important prognosticator for a SLP. A latency period of >24 h was associated with chorioamnionitis, but adverse neonatal outcomes were not observed.

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“…However, another study showed that a prolonged latency period (≥72 h) did not increase maternal morbidities such as Chorioamnionitis ( 69 ). The disagreement between these studies could be attributed to variations in the sample size used, GA at delivery, maternal age, maternal social factors, and maternal comorbidities during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Determinants for perinatal adverse outcomes among pregnant women with preterm premature rupture of membrane: A prospective cohort study

Abebe

Nima

Mariye

et al. 2022

Front. Reprod. Health

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BackgroundOne of the most critical functions of the fetal membranes is to remain intact until the onset of labor to maintain the protective intrauterine fluid environment. In most pregnancies, spontaneous rupture usually occurs near the end of the first stage of labor. Preterm premature membrane rupture (PROM) occurs when the fetal membrane ruptures before 37 weeks of pregnancy, and it contributes to adverse maternal, fetal, and neonatal outcomes. Therefore, this study aimed to determine the association of determinant factors with adverse perinatal outcomes.MethodsA prospective cohort study was conducted on pregnant women with preterm premature membrane rupture (n = 160) attending the teaching hospitals at Addis Ababa University. Socio-demographic and obstetric risk factors with adverse perinatal outcomes include the 5th minute Apgar score, neonatal intensive care unit (NICU) admission, early-onset neonatal sepsis (EONS), respiratory distress syndrome (RDS), perinatal mortality, Chorioamnionitis, and placental abruption were assessed. SPSS version 24, t-test, χ2 test, and logistic regression analysis were used. P-values <0.25 in the bivariate and p < 0.05 in the multiple logistic regression were considered statistically significant.ResultsThe preterm (PROM) rate was 2.2% with perinatal mortality rate of 206/1,000. Gestational age (GA) at delivery was the determinate for low Apgar score at the 5th minute (AOR: 7.23; 95% CI, 1.10, 47.6; p = 0.04). Unable to use steroid (AOR: 8.23; 95% CI, 1.83, 37.0; p = 0.000), GA at membrane rupture (AOR: 4.61; 95% CI, 1.98, 31.8; p = 0.000) and delivery (AOR: 4.32; 95% CI, 1.99, 30.9; p = 0.000) were determinates for NICU admission. EONS was significantly affected by GA at membrane rupture (AOR: 5.9; 95% CI, 1.01, 37.0; p = 0.04). Placental abruption was significantly affected by GA at delivery (AOR: 7.52; 95% CI, 1.15, 48.96; p = 0.04).ConclusionGA at membrane rupture and delivery was the most critical predictors of adverse perinatal outcomes. Local guidelines on the approach and preterm PROM outcome management need to be prepared.

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

Cited by 7 publications

References 19 publications

Perinatal Outcomes of Pregnancies with Preterm Premature Rupture of Membranes after 34 Weeks of Gestation

Perinatal Outcomes of Pregnancies with Preterm Premature Rupture of Membranes after 34 Weeks of Gestation

Clinical Factors and Perinatal Outcomes Associated With Short Latency Period in Twin Pregnancies With Preterm Premature Rupture of Membranes Before 34 Weeks: A Retrospective Study

Determinants for perinatal adverse outcomes among pregnant women with preterm premature rupture of membrane: A prospective cohort study

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