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Analysis of patients with premature rupture of membranes
between 22 and 33 weeks of gestation
| 1 | Katedra i Oddział Kliniczny Ginekologii, Położnictwa i Ginekologii Onkologicznej, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach |
| 2 | Oddział Ginekologii i Położnictwa, Szpital Wojewódzki w Bielsku-Białej |
CORRESPONDING AUTHOR
Dorota Knapik
Katedra i Oddział Kliniczny Ginekologii, Położnictwa i Ginekologii Onkologicznej, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach Szpital Specjalistyczny Nr 2, ul. St. Batorego 15, 41-902 Bytom,
Katedra i Oddział Kliniczny Ginekologii, Położnictwa i Ginekologii Onkologicznej, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach Szpital Specjalistyczny Nr 2, ul. St. Batorego 15, 41-902 Bytom,
Ann. Acad. Med. Siles. 2018;72:244–251
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The rupture of amniotic membranes between 22 and 33 weeks of gestation (PPROM) is a particular clinical scenario, when survival of the newborn is uncertain, but possible. The aim of the study was to provide a full spectrum of problems in diagnosis and treatment of a pregnant woman with PPROM.
Material and methods:
The course of treatment in 38 pregnant women aged 18 to 42 years admitted to hospital between 22 and 33 weeks of gestation because of suspected PPROM was analyzed. Complete data regarding the diagnostic process, treatment and further course of pregnancy were collected. The results were statistically analyzed.
Results:
PPROM was confirmed in 31 patients. The mean gestational age when PPROM occurred was 28.2 weeks. Ultrasound examination had a very high diagnostic value in the diagnosis of PPROM. The mean latency period in women with confirmed PPROM was 11 days, but the obtained range was enormous (1–85 days) and did not show any significant correlation with gestational age (r = 0.29, p = 0.106). At the end of the follow-up (one month after birth) 16% of the newborns had died and another 16% were still in the hospital with an uncertain prognosis for survival. No deaths were noted among the neonates in the group where delivery occurred at 32 weeks or later.
Conclusions:
Mortality among newborns resulting from PPROM is variable and dependent on gestational age. Preliminary clinical examination should always be confirmed by ultrasound. Because of its socio-economic burden, this issue deserves further prospective studies.
The rupture of amniotic membranes between 22 and 33 weeks of gestation (PPROM) is a particular clinical scenario, when survival of the newborn is uncertain, but possible. The aim of the study was to provide a full spectrum of problems in diagnosis and treatment of a pregnant woman with PPROM.
Material and methods:
The course of treatment in 38 pregnant women aged 18 to 42 years admitted to hospital between 22 and 33 weeks of gestation because of suspected PPROM was analyzed. Complete data regarding the diagnostic process, treatment and further course of pregnancy were collected. The results were statistically analyzed.
Results:
PPROM was confirmed in 31 patients. The mean gestational age when PPROM occurred was 28.2 weeks. Ultrasound examination had a very high diagnostic value in the diagnosis of PPROM. The mean latency period in women with confirmed PPROM was 11 days, but the obtained range was enormous (1–85 days) and did not show any significant correlation with gestational age (r = 0.29, p = 0.106). At the end of the follow-up (one month after birth) 16% of the newborns had died and another 16% were still in the hospital with an uncertain prognosis for survival. No deaths were noted among the neonates in the group where delivery occurred at 32 weeks or later.
Conclusions:
Mortality among newborns resulting from PPROM is variable and dependent on gestational age. Preliminary clinical examination should always be confirmed by ultrasound. Because of its socio-economic burden, this issue deserves further prospective studies.
REFERENCES (17)
1.
Falk S.J., Campbell L.J., Lee-Parritz A., Cohen A.P., Ecker J., Wilkins-Haug L., Lieberman E. Expectant management in spontaneous preterm premature rupture of membranes between 14 and 24 weeks’ gestation. J. Perinatol. 2004; 24(10): 611–616.
2.
van der Ham D.P., van Teeffelen A.S., Mol B.W. Prelabour rupture of membranes: overview of diagnostic methods. Curr. Opin. Obstet. Gynecol. 2012; 24(6): 408–412, doi: 10.1097/GCO.0b013e328359825c.
3.
El-Messidi A., Cameron A. Diagnosis of premature rupture of membranes: inspiration from the past and insights for the future. J. Obstet. Gynaecol. Can. 2010; 32(6): 561–569, doi: 10.1016/S1701-2163(16)34525-X.
4.
van der Ham D.P., van Melick M.J., Smits L., Nijhuis J.G., Weiner C.P., van Beek J.H., Mol B.W., Willekes C. Methods for the diagnosis of rupture of the fetal membranes in equivocal cases: a systematic review. Eur. J. Obstet. Gynecol. Reprod. Biol. 2011; 157(2): 123–127, doi: 10.1016/j.ejogrb.2011.03.006.
5.
Caughey A.B., Robinson J.N., Norwitz E.R. Contemporary diagnosis and management of preterm premature rupture of membranes. Rev. Obstet. Gynecol. 2008; 1(1): 11–22.
6.
Sun L., Tao F., Hao J., Su P., Xu R., Liu F. Vaginal bleeding in early pregnancy and associations with physical, psychological and environmental factors among Chinese women: from the C-ABC cohort study. Gynecol. Obstet. Invest. 2012; 73(4): 330–336, doi: 10.1159/000336402.
7.
Velez Edwards D.R., Baird D.D., Hasan R., Savitz D.A., Hartmann K.E. First-trimester bleeding characteristics associate with increased risk of preterm birth: data from a prospective pregnancy cohort. Hum. Reprod. 2012; 27(1): 54–60, doi: 10.1093/humrep/der354.
8.
Moghaddam Banaem L., Mohamadi B., Asghari Jaafarabadi M., Aliyan Moghadam N. Maternal serum C-reactive protein in early pregnancy and occurrence of preterm premature rupture of membranes and preterm birth. J. Obstet. Gynaecol. Res. 2012; 38(5): 780–786, doi: 10.1111/j.1447-0756.2011.01804.x.
9.
Menon R., Fortunato S.J. Infection and the role of inflammation in preterm premature rupture of the membranes. Best Pract. Res. Clin. Obstet. Gynaecol. 2007; 21(3): 467–478.
10.
Ryu A., Park K.H., Oh K.J., Lee S.Y., Jeong E.H., Park J.W. Predictive value of combined cervicovaginal cytokines and gestational age at sampling for intra-amniotic infection in preterm premature rupture of membranes. Acta Obstet. Gynecol. Scand. 2013; 92(5): 517–524, doi: 10.1111/aogs.12073.
11.
Harding J.E., Pang J., Knight D.B., Liggins G.C. Do antenatal corticosteroids help in the setting of preterm rupture of membranes? Am. J. Obstet. Gynecol. 2001; 184(2): 131–139.
12.
Restrictions on use of short-acting beta-agonists in obstetric indications – CMDh endorses PRAC recommendations. EMA/565019/2013, European Medicines Agency, 2013. [Wydruk u autora], dostępne: https://www.ema.europa.eu/docu....
13.
Giles M., Garland S., Oats J.J. Management of preterm prelabour rupture of membranes: an audit. How do the results compare with clinical practice guidelines? Aust. N. Z. J. Obstet. Gynaecol. 2005; 45(3): 201–206.
14.
Test G., Levy A., Wiznitzer A., Mazor M., Holcberg G., Zlotnik A., Sheiner E. Factors affecting the latency period in patients with preterm premature rupture of membranes. Arch. Gynecol. Obstet. 2011; 283(4): 707–710, doi: 10.1007/s00404-010-1448-7.
15.
Dinsmoor M.J., Bachman R., Haney E.I., Goldstein M., Mackendrick W. Outcomes after expectant management of extremely preterm premature rupture of the membranes. Am. J. Obstet. Gynecol. 2004; 190(1): 183–187.
16.
Dewan H., Morris J.M. A systematic review of pregnancy outcome following preterm premature rupture of membranes at a previable gestational age. Aust. N. Z. J. Obstet. Gynaecol. 2001; 41(4): 389–394.
17.
Messerschmidt A., Olischar M., Birnbacher R., Sauer A., Weber M., Puschnig D., Unterasinger L., Pollak A., Leitich H. Is it Possible to Make a Reliable Prognosis within the First Hour of Life for Very Low Birth Weight Infants Delivered after Preterm Premature Rupture of Membranes? Neonato-logy 2011; 99(2): 146–152, doi: 10.1159/000313969.
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