Prevention of PPROM: Current and future strategies

Mingione, Matthew; Pressman, Eva; Woods, James R.

doi:10.1080/14767050600967797

Cited by 16 publications

(11 citation statements)

References 45 publications

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“…Major etiologic factors contributing to the pathogenesis are subclinical intrauterine infections and obstetrical characteristics of the current as well as previous pregnancies. Recent studies further attribute genetic, nutritional, behavioral and environmental factors an important role in this setting [17,18] . iPPROM, however, is characterized by a different underlying pathophysiology: here, the medical instrument creates the hole in the membranes, which subsequently fails to close [19] .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature

Beck¹,

Lewi²,

Gucciardo³

et al. 2011

Fetal Diagn Ther

124

138

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Objective: Iatrogenic preterm prelabor rupture of membranes (iPPROM; <37 weeks of gestation) is a major complication of fetal surgery. Little information is available about risk factors and incidence. Methods: We systematically reviewed reported iPPROM rates, gestational age at delivery and fetal survival after representative minimally invasive antenatal procedures. Results: A total of 1,146, 36 and 194 cases with mean iPPROM rates of 27, 31 and 26% were included for placental laser in twin-twin transfusion syndrome, shunting in lower urinary tract obstruction and interventions for twin-reversed arterial perfusion, respectively. In the statistical analysis, the maximum diameter of the instrument predicted iPPROM rate and was significantly related to gestational age at birth as well as fetal survival. Information on duration of the respective procedures was scarce and did not allow for meaningful analysis. Conclusions: iPPROM occurs in about 30% of cases treated by minimally invasive fetal surgery. The maximum diameter of the instrument explains iPPROM rate, gestational age at birth and fetal survival. Great variations in the reporting of iPPROM make data analysis difficult.

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Section: Discussionmentioning

confidence: 99%

“…during the second screening. Reasons for exclusion were: insufficient information (18), review (10), membrane sealing (8), double report (7), single case report (3), unrelated topic (3), animal study (1), language (1) and editorial (1). This left 12 publications on 1,146 cases for inclusion in our review ( table 1 a).…”

Section: Placental Laser Ablation For Tttsmentioning

confidence: 99%

Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature

Beck¹,

Lewi²,

Gucciardo³

et al. 2011

Fetal Diagn Ther

124

138

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“…20 However, it is unlikely that a ''susceptible'' genotype is sufficient to result in PPROM. More likely, genetic susceptibility may combine with an environmental trigger, such as intrauterine infection, resulting in an exaggerated proinflammatory response that leads to PPROM.…”

Section: Genetic Susceptibilitymentioning

confidence: 99%

Impact of Preterm PROM and its Complications on Long-term Infant Outcomes

Clark

Varner²

2011

Clinical Obstetrics &Amp; Gynecology

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There is increasing evidence that preterm premature rupture of membranes (PPROM) is associated with increased risk for adverse neurodevelopmental outcomes through multiple mechanisms, including preterm birth and its antecedent etiologies. Intrauterine infection is a particularly important risk factor for adverse neurodevelopmental outcomes after PPROM. This review focuses on the long-term neurodevelopmental outcomes after PPROM, the possible etiologic mechanisms of neurological injury, and the effect of antenatal and perinatal interventions using available evidence.

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“…4 The etiology of PPROM is multifactorial, with nutritional, environmental, and genetic contributors working singularly or synergistically. 5,6 Clinical risk factors have been proposed to identify women at highest risk of PPROM, including short cervical length at 23 to 24 weeks gestation, positive fetal fibronectin screening, and a history of prior PPROM. 7 These clinical risk factors generate PPROM through pathways involved in the upregulation of the inflammatory process.…”

Section: Introductionmentioning

confidence: 99%

Serum Decorin and Biglycan as Potential Biomarkers to Predict PPROM in Early Gestation

et al. 2020

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Preterm birth is a leading cause of neonatal mortality in the US and globally, with preterm premature rupture of fetal membranes (PPROM) accounting for one third of preterm births. Currently no predictive diagnostics are available to precisely assess risk and potentially reduce the incidence of PPROM. Bigycan and decorin, the main proteoglycans present in human fetal membranes, are involved in the physiological maturation of fetal membranes as well as in the pathophysiology of preterm birth. The serum protein sex hormone-binding globulin (SHBG) has recently been identified as a predictor of spontaneous preterm birth. We hypothesize that the balance between serum decorin and biglycan on one hand and SHBG on the other hand may provide insight into the status of the fetal membranes in early pregnancy, thereby predicting PPROM prior to symptoms. Using chart review, 18 patients with confirmed cases of PPROM were identified from 2013-2016. Second trimester residual serum was retreived from freezer storage for these cases along with 5 matched controls for each case. The biomarkers biglycan, decorin and SHBG were analyzed first separately, then in combination to determine their ability to predict PPROM. The predictive score for the combined model displays an AUC ¼ 0.774. The ROC curve of the predicted score has an optimal threshold of 0.238 and a sensitivity and specificity of 0.72 and 0.84 respectively. This prenatal serum panel is a promising serum screening-based biochemical model to predict PPROM in asymptomatic women.

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Prevention of PPROM: Current and future strategies

Cited by 16 publications

References 45 publications

Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature

Preterm Prelabor Rupture of Membranes and Fetal Survival after Minimally Invasive Fetal Surgery: A Systematic Review of the Literature

Impact of Preterm PROM and its Complications on Long-term Infant Outcomes

Serum Decorin and Biglycan as Potential Biomarkers to Predict PPROM in Early Gestation

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