open access

Vol 90, No 11 (2019)
Research paper
Published online: 2019-11-28
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Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation

Malgorzata Swiatkowska-Freund1, Anetta Traczyk-Łos1, Anna Partyka1, Kamil Obara1, Altankhorol Damdinsuren1, Krzysztof Preis1
·
Pubmed: 31802465
·
Ginekol Pol 2019;90(11):645-650.
Affiliations
  1. Department of Obstetrics, Medical University of Gdansk, Poland

open access

Vol 90, No 11 (2019)
ORIGINAL PAPERS Obstetrics
Published online: 2019-11-28

Abstract

Objectives: The aim of this study was to assess the maternal and neonatal outcome in patients with preterm premature rupture of membranes between 22 to 37 weeks of gestation in comparison to preterm birth patients. 

Material and methods: Group of PPROM patients consisted of 127 women, the control group counted 141 women who delivered prematurely. The control group was formed by matching patient with the same gestational age at delivery and neonatal birth weight to every woman from study group. In both groups speculum and ultrasound examinations were performed, microbiological swabs were taken. In unclear cases of PPROM tests detecting amniotic proteins, such as PAMG-1 or IGFBP-1, were performed. According to gestational age at delivery, neonates were divided into subgroups: extremely premature infants (< 27 weeks 6 days), moderate premature infants (from 28 weeks 0 days to 33 weeks 6 days), late premature infants (from 34 weeks 0 days to 37 weeks 0 days). 

Results: In the study group, median gestational age of delivery was 34 weeks 1 day and the same in control group — 34 weeks and 5 days (p > 0.05). Parameters of inflammatory status were more often reported in the PPROM group than in the preterm birth group, even if they weren’t statistically significant (positive culture of cervical swab, increased leukocytosis, CRP above 5). The rate of neonate survival was similar in both groups (93.7% and 94.1%). Congenital infection was more often diagnosed in group of neonates from PPROM pregnancies than in neonates from control group; (36% and 21.2% respectively; p = 0.009). 

Conclusions: Our research appears to be consistent with theory of inflammatory etiology of PPROM. Optimal management of infection in PPROM patients seems to be the most important in efforts to prolong pregnancy.

Abstract

Objectives: The aim of this study was to assess the maternal and neonatal outcome in patients with preterm premature rupture of membranes between 22 to 37 weeks of gestation in comparison to preterm birth patients. 

Material and methods: Group of PPROM patients consisted of 127 women, the control group counted 141 women who delivered prematurely. The control group was formed by matching patient with the same gestational age at delivery and neonatal birth weight to every woman from study group. In both groups speculum and ultrasound examinations were performed, microbiological swabs were taken. In unclear cases of PPROM tests detecting amniotic proteins, such as PAMG-1 or IGFBP-1, were performed. According to gestational age at delivery, neonates were divided into subgroups: extremely premature infants (< 27 weeks 6 days), moderate premature infants (from 28 weeks 0 days to 33 weeks 6 days), late premature infants (from 34 weeks 0 days to 37 weeks 0 days). 

Results: In the study group, median gestational age of delivery was 34 weeks 1 day and the same in control group — 34 weeks and 5 days (p > 0.05). Parameters of inflammatory status were more often reported in the PPROM group than in the preterm birth group, even if they weren’t statistically significant (positive culture of cervical swab, increased leukocytosis, CRP above 5). The rate of neonate survival was similar in both groups (93.7% and 94.1%). Congenital infection was more often diagnosed in group of neonates from PPROM pregnancies than in neonates from control group; (36% and 21.2% respectively; p = 0.009). 

Conclusions: Our research appears to be consistent with theory of inflammatory etiology of PPROM. Optimal management of infection in PPROM patients seems to be the most important in efforts to prolong pregnancy.

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Keywords

1 preterm delivery; 2 preterm premature rupture of membranes; 3 neonatology autcome

About this article
Title

Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation

Journal

Ginekologia Polska

Issue

Vol 90, No 11 (2019)

Article type

Research paper

Pages

645-650

Published online

2019-11-28

Page views

2128

Article views/downloads

1822

DOI

10.5603/GP.2019.0109

Pubmed

31802465

Bibliographic record

Ginekol Pol 2019;90(11):645-650.

Keywords

1 preterm delivery
2 preterm premature rupture of membranes
3 neonatology autcome

Authors

Malgorzata Swiatkowska-Freund
Anetta Traczyk-Łos
Anna Partyka
Kamil Obara
Altankhorol Damdinsuren
Krzysztof Preis

References (22)
  1. Harger JH, Toumala RE, Gibbs RS, et al. Premature rupture of membranes. Obstet Gynecol. 2013; 122: 918–930.
  2. Getahun D, Strickland D, Ananth CV, et al. Recurrence of preterm premature rupture of membranes in relation to interval between pregnancies. Am J Obstet Gynecol. 2010; 202(6): 570.e1–570.e6.
  3. Mercer BM. Preterm premature rupture of the membranes. Obstet Gynecol. 2003; 101(1): 178–193.
  4. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 172: Premature Rupture of Membranes. Obstet Gynecol. 2016; 128(4): e165–e177.
  5. Jazayeri A, Jazayeri MK, Sutkin G. Tocolysis does not improve neonatal outcome in patients with preterm rupture of membranes. Am J Perinatol. 2003; 20(4): 189–193.
  6. Ehsanipoor RM, Shrivastava VK, Lee RM, et al. A randomized, double-masked trial of prophylactic indomethacin tocolysis versus placebo in women with premature rupture of membranes. Am J Perinatol. 2011; 28(6): 473–478.
  7. Waters TP, Mercer BM. The management of preterm premature rupture of the membranes near the limit of fetal viability. Am J Obstet Gynecol. 2009; 201(3): 230–240.
  8. Winn HN, Chen M, Amon E, et al. Neonatal pulmonary hypoplasia and perinatal mortality in patients with midtrimester rupture of amniotic membranes--a critical analysis. Am J Obstet Gynecol. 2000; 182(6): 1638–1644.
  9. Sciscione AC, Manley JS, Pollock M, et al. Intracervical fibrin sealants: a potential treatment for early preterm premature rupture of the membranes. Am J Obstet Gynecol. 2001; 184(3): 368–373.
  10. Singla A, Yadav P, Vaid NB, et al. Transabdominal amnioinfusion in preterm premature rupture of membranes. Int J Gynaecol Obstet. 2010; 108(3): 199–202.
  11. Romero R, Gomez R, Mazor M, et al. The preterm labor syndrome. In: Elder MG, Lamont RF. ed. Preterm labor. Churchill Livingstone, New York 1997: 29–49.
  12. Gotsch F, Romero R, Erez O, et al. The preterm parturition syndrome and its implications for understanding the biology, risk assessment, diagnosis, treatment and prevention of preterm birth. J Matern Fetal Neonatal Med. 2009; 22 Suppl 2: 5–23.
  13. Draper D, Jones W, Heine RP, et al. Trichomonas vaginalis Weakens human Amniochorion in an in vitro model of premature membrane rupture. Infect Dis Obstet Gynecol. 1995; 2(6): 267–274.
  14. Romero R, Salafia CM, Athanassiadis AP, et al. The relationship between acute inflammatory lesions of the preterm placenta and amniotic fluid microbiology. Am J Obstet Gynecol. 1992; 166(5): 1382–1388.
  15. Carroll SG, Papaioannou S, Ntumazah IL, et al. Lower genital tract swabs in the prediction of intrauterine infection in preterm prelabour rupture of the membranes. Br J Obstet Gynaecol. 1996; 103(1): 54–59.
  16. Ismail MA, Zinaman MJ, Lowensohn RI, et al. The significance of C-reactive protein levels in women with premature rupture of membranes. Am J Obstet Gynecol. 1985; 151(4): 541–544.
  17. Watts DH, Krohn MA, Hillier SL, et al. Characteristics of women in preterm labor associated with elevated C-reactive protein levels. Obstet Gynecol. 1993; 82(4 Pt 1): 509–514.
  18. Peaceman AM, Lai Y, Rouse DJ, et al. Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Length of latency with preterm premature rupture of membranes before 32 weeks' gestation. Am J Perinatol. 2015; 32(1): 57–62.
  19. Moretti M, Sibai BM. Maternal and perinatal outcome of expectant management of premature rupture of membranes in the midtrimester. Am J Obstet Gynecol. 1988; 159(2): 390–396.
  20. BENGTSON J, VanMARTER L, BARSS V, et al. Pregnancy Outcome After Premature Rupture of the Membranes at or Before 26 Weeksʼ Gestation. Am J Obstet Gynecol. 1989; 73(6): 921–927.
  21. Dale PO, Tanbo T, Bendvold E, et al. Duration of the latency period in preterm premature rupture of the membranes. Maternal and neonatal consequences of expectant management. Eur J Obstet Gynecol Reprod Biol. 1989; 30(3): 257–262.
  22. Glass HC, Costarino AT, Stayer SA, et al. Outcomes for extremely premature infants. Anesth Analg. 2015; 120(6): 1337–1351.

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