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Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):146-151
DOI 10.1590/S0100-720320140050.0003
To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM).
An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume. Pregnant women were compared at two cut-off points: those with AFI <5.0 and ≥5.0 cm and AFI <3.0 and ≥3.0 cm. We excluded women with hypertensive disorders, diabetesmellitus, fetal malformations and a diagnosis of infections at admission. For statistical analysis, we used the χ2test or Fisher's exact test, when appropriate, and simple linear regression analysis, with the level of significance set at 5%. We calculated the Risk Ratio (RR) and its 95% confidence interval (95%CI).
When maternal outcomes were assessed by comparing ILA ≥5.0versus <5.0 cm, no significant differences were detected. However, when considering ILA <3.0 and ≥3.0 cm, there was an increased risk of chorioamnionitis (36.7 versus10.7%, RR: 3.4, 95%CI 1.4 -8.3, p=0.004), with no significant differences for the other variables. There was also a statistically significant positive correlation between AFI and gestational age at delivery (R2=0.78, p<0.0001).
AFI <3.0 cm causes a three-fold increase in the risk for chorioamnionitis; also, the higher the ILA, the higher the gestational age at delivery.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):146-151
DOI 10.1590/S0100-720320140050.0003
To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM).
An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume. Pregnant women were compared at two cut-off points: those with AFI <5.0 and ≥5.0 cm and AFI <3.0 and ≥3.0 cm. We excluded women with hypertensive disorders, diabetesmellitus, fetal malformations and a diagnosis of infections at admission. For statistical analysis, we used the χ2test or Fisher's exact test, when appropriate, and simple linear regression analysis, with the level of significance set at 5%. We calculated the Risk Ratio (RR) and its 95% confidence interval (95%CI).
When maternal outcomes were assessed by comparing ILA ≥5.0versus <5.0 cm, no significant differences were detected. However, when considering ILA <3.0 and ≥3.0 cm, there was an increased risk of chorioamnionitis (36.7 versus10.7%, RR: 3.4, 95%CI 1.4 -8.3, p=0.004), with no significant differences for the other variables. There was also a statistically significant positive correlation between AFI and gestational age at delivery (R2=0.78, p<0.0001).
AFI <3.0 cm causes a three-fold increase in the risk for chorioamnionitis; also, the higher the ILA, the higher the gestational age at delivery.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):296-302
DOI 10.1590/SO100-720320140004958
To describe the perinatal outcomes after preterm premature rupture of membranes.
A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded. The pregnant women were hospitalized for conservative treatment with corticosteroids, antibiotics and tocolysis with nifedipine if necessary. The results are reported as frequency distributions and measures of central tendency and dispersion.
Seventeen patients (13.7%) had a gestational age of less than 24 weeks. Mean maternal age was 25.7 years, mean gestational age at the diagnosis of preterm premature rupture of membranes was 29 weeks, mean amniotic fluid index was 3.5 cm, and mean latency period was 10.5 days. Most patients went into spontaneous labor by the 30th week of pregnancy, and the rate of vaginal delivery was 88.2%. Chorioamnionitis was the most frequent maternal complication (34.7%). Neonatal sepsis was observed in 12% of patients, and the perinatal mortality rate was 21.5% for the group at or beyond the 24th week of gestation and 76.5% for the group with less than 24 weeks of gestational age.
A low maternal mortality rate was observed in preterm premature rupture of membranes; however, high rates of complications and perinatal death were observed, suggesting that other conduct protocols should be studied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):296-302
DOI 10.1590/SO100-720320140004958
To describe the perinatal outcomes after preterm premature rupture of membranes.
A retrospective cohort study was carried out at Instituto de Medicina Integral Prof. Fernando Figueira - IMIP from January 2008 to December 2012. A total of 124 preterm premature rupture of membranes singleton pregnancies, with gestational age <35, were included in the study. Pregnant women carrying fetuses with malformations, hypertensive syndromes, diabetes, or diagnosis of infections at admission were excluded. The pregnant women were hospitalized for conservative treatment with corticosteroids, antibiotics and tocolysis with nifedipine if necessary. The results are reported as frequency distributions and measures of central tendency and dispersion.
Seventeen patients (13.7%) had a gestational age of less than 24 weeks. Mean maternal age was 25.7 years, mean gestational age at the diagnosis of preterm premature rupture of membranes was 29 weeks, mean amniotic fluid index was 3.5 cm, and mean latency period was 10.5 days. Most patients went into spontaneous labor by the 30th week of pregnancy, and the rate of vaginal delivery was 88.2%. Chorioamnionitis was the most frequent maternal complication (34.7%). Neonatal sepsis was observed in 12% of patients, and the perinatal mortality rate was 21.5% for the group at or beyond the 24th week of gestation and 76.5% for the group with less than 24 weeks of gestational age.
A low maternal mortality rate was observed in preterm premature rupture of membranes; however, high rates of complications and perinatal death were observed, suggesting that other conduct protocols should be studied.