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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.
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