The association of the amniotic fluid index (AFI) with perinatal fetal and maternal outcomes in pregnancies complicated by preterm premature rupture of membranes (PPROM)

Abstract

Objectives: To investigate association of amniotic fluid index (AFI) with perinatal fetal and maternal outcomes in pregnancies complicated by preterm premature rupture of membranes (PPROM) Material and methods: A total of 70 singleton pregnancies complicated by PPROM at 23-33 weeks' gestation were enrolled in this prospective observational study. Data on maternal clinical and obstetric characteristics [maternal age, gravidity, parity, PPROM time, and AFI (cm), latency period, treatments, type of delivery, length of hospital stay (LOS, day)], fetal characteristics (gestational age at delivery, birth weight (g), gender) and maternal and fetal complications were recorded and compared in AFI < 5 cm (n = 27) and AFI ≥ 5 cm (n = 21) groups. Results: Overall AFI was ≤ 5 cm in 27 (56.3%) patients and > 5 cm in 21 (43.7%) patients. No significant difference was noted in maternal clinical and obstetric characteristics, gestational age at delivery and gender of the newborn as well as in maternal and fetal complications rates with respect to AFI groups. AFI was correlated positively with latency period (r = 0.399, p = 0.018) and negatively with postpartum LOS (r =-0.314, p = 0.030). Conclusions: In conclusion, our findings seems to indicate increased likelihood of shorter latency to delivery and longer postpartum LOS with decrease in AFI after PPROM between 23-33 weeks' gestation, whereas no impact of AFI on mode of delivery and fetal or maternal complications.

Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

“… 12–14 As there is no obvious way to risk-stratify pregnancies complicated by pPPROM at this time, and given that many of these cases will receive an obstetric ultrasound to evaluate fetal well-being, there remains a question about the potential role of amniotic fluid volume measurement in predicting outcome after previable membrane rupture. 15 , 16 The goal of this study was to determine the perinatal outcomes and influence of amniotic fluid volume in pregnancies complicated by previable, preterm prelabor rupture of membranes (pPPROM). The results of this study could be used to refine patient counseling and develop management strategies to improve outcomes, as well as to direct much-needed future research.…”

Platelets and White Blood Corpuscles' Indices for the Prediction of Premature Rupture of Membranes

“…Mousavi et al (21) reported that, PPROM is associated with lower AFI (<5.0). However, Günay et al (22) could not identify such association (PPROM and low AFI), although they linked unfavorable outcome with lower AFI.…”

Single Nucleotide Polymorphisms from CSF2, FLT1, TFPI and TLR9 Genes Are Associated with Prelabor Rupture of Membranes

“…In turn, pPROM affects about 3-4% of all births, causing one-third of all preterm labors and being one of the most serious complications of pregnancy [5][6][7]. The occurrence of pPROM is accompanied by increased maternal and offspring morbidity, as well as fetal and neonatal mortality [8][9][10]. PPROM is associated with an increased risk of intra-amniotic infection, acute and chronic histological chorioamnionitis, clinical chorioamnionitis, cord prolapse, placental abruption and postpartum endometritis [8][9][10][11].…”

“…The occurrence of pPROM is accompanied by increased maternal and offspring morbidity, as well as fetal and neonatal mortality [8][9][10]. PPROM is associated with an increased risk of intra-amniotic infection, acute and chronic histological chorioamnionitis, clinical chorioamnionitis, cord prolapse, placental abruption and postpartum endometritis [8][9][10][11]. The complications in neonates include pulmonary hypoplasia, respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), adverse neurodevelopmental outcomes, intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), cardiovascular diseases, necrotizing enterocolitis (NEC), sepsis and death [9,10].…”