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Archives of Gynecology and Obstetrics

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01-09-2019 | Premature Rupture of Membranes | Maternal-Fetal Medicine

Can we predict preterm delivery in patients with premature rupture of membranes?

Authors: Yael Yagur, Omer Weitzner, Eyal Ravid, Tal Biron-Shental

Published in: Archives of Gynecology and Obstetrics | Issue 3/2019

Abstract

Purpose

To characterize the parameters that predict preterm delivery in patients with preterm, premature rupture of membranes.

Methods

This retrospective cohort study included women diagnosed with preterm premature rupture of membranes at 24–34 weeks gestation. Demographics, medical history, laboratory tests, and delivery data were reviewed.

Results

Among 258 patients with preterm, premature rupture of membranes during the study period, 141 (54.7%) met the inclusion criteria. Therefore, the final cohort included 141 (54.78%) women, among whom, 32 (22.7%) delivered within the first 24 h of ROM and 109 (77.3%) delivered after 24 h. Univariant analysis revealed that advanced gestational age at the time of preterm, premature rupture of membranes, larger cervical dilation and leukocyte count at admission had significant effects on the likelihood of labor within 24 h. Analysis of the differences between each patient at admission to 24 h before labor in heart rate, temperature (fever), leukocyte counts and amniotic fluid color revealed significant changes in heart rate (P < 0.001), leukocyte count (P < 0.001) and in amniotic fluid from clean to meconium or bloody (P < 0.001). There was no significant change in elevated temperature (P = 0.065).

Conclusions

Our findings indicate that minimal changes in heart rate, body temperature (fever), leukocyte count and amniotic fluid color, within normal ranges, appear 24 h before delivery, among women with preterm, premature rupture of membranes and prolonged latency period. Increased attention to these changes might enable better follow-up and timing of delivery for patients with preterm, premature rupture of membranes before 34 weeks gestation.

American College of Obstetricians and Gynecologists (2013) ACOG Practice bulletin No. 139: premature rupture of membranes. Obstet Gynecol 122:918–930. https://doi.org/10.1097/01.AOG.0000435415.21944.8f CrossRef

Waters TP, Mercer B (2011) Preterm PROM: prediction, prevention, principles. Clin Obstet Gynecol 54:307–312. https://doi.org/10.1097/GRF.0b013e318217d4d3 CrossRefPubMed

Matthews TJ, MacDorman MF (2013) Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep 62:1–26PubMed

Bond DM, Middleton P, Levett KM, van der Ham DP, Crowther CA, Buchanan SL et al (2017) Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks’ gestation for improving pregnancy outcome. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD004735.pub4 CrossRefPubMedPubMedCentral

Naef RW, Allbert JR, Ross EL, Weber BM, Martin RW, Morrison JC (1998) Premature rupture of membranes at 34 to 37 weeks’ gestation: aggressive versus conservative management. Am J Obstet Gynecol 178:126–130. https://doi.org/10.1016/S0002-9378(98)70638-6 CrossRefPubMed

Kenyon S, Boulvain M, Neilson JP (2013) Antibiotics for preterm rupture of membranes. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD001058.pub3

Ananth CV, Oyelese Y, Srinivas N, Yeo L, Vintzileos AM (2004) Preterm premature rupture of membranes, intrauterine infection, and oligohydramnios: risk factors for placental abruption. Obstet Gynecol 104:71–77. https://doi.org/10.1097/01.AOG.0000128172.71408.a0 CrossRefPubMed

Mercer BM (2003) Preterm premature rupture of the membranes. Obstet Gynecol 101:178–193. https://doi.org/10.1016/S0029-7844(02)02366-9 CrossRefPubMed

Teune MJ, Bakhuizen S, Bannerman CG, Opmeer BC, Van Kaam AH, Van Wassenaer AG et al (2011) A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2011.07.015 CrossRefPubMed

10.

McGowan JE, Alderdice FA, Holmes VA, Johnston L (2011) Early childhood development of late-preterm infants: a systematic review. Pediatrics 127:1111–1124. https://doi.org/10.1542/peds.2010-2257 CrossRefPubMed

11.

Van Der Ham DP, Van Der Heyden JL, Opmeer BC, Mulder ALM, Moonen RMJ, Van Beek JJ et al (2012) Management of late-preterm premature rupture of membranes: the PPROMEXIL-2 trial. Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2012.07.024 CrossRefPubMed

12.

Quist-Nelson J, de Ruigh AA, Seidler AL, van der Ham DP, Willekes C, Berghella V et al (2018) Immediate delivery compared with expectant management in late preterm prelabor rupture of membranes: an individual participant data meta-analysis. Obstet Gynecol 131:269–279. https://doi.org/10.1097/AOG.0000000000002447 CrossRefPubMed

13.

Goya M, Bernabeu A, García N, Plata J, Gonzalez F, Merced C et al (2013) Premature rupture of membranes before 34 weeks managed expectantly: maternal and perinatal outcomes in singletons. J Matern Fetal Neonatal Med 26:290–293. https://doi.org/10.3109/14767058.2012.733779 CrossRefPubMed

14.

Melamed N, Hadar E, Ben-Haroush A, Kaplan B, Yogev Y (2009) Factors affecting the duration of the latency period in preterm premature rupture of membranes. J Matern Neonatal Med 22:1051–1056. https://doi.org/10.3109/14767050903019650 CrossRef

15.

Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A et al (2011) Factors affecting the latency period in patients with preterm premature rupture of membranes. Arch Gynecol Obstet 283:707–710. https://doi.org/10.1007/s00404-010-1448-7 CrossRefPubMed

16.

Melamed N, Ben-Haroush A, Pardo J, Chen R, Hadar E, Hod M et al (2011) Expectant management of preterm premature rupture of membranes: is it all about gestational age? Am J Obstet Gynecol. https://doi.org/10.1016/j.ajog.2010.08.021 CrossRefPubMed

17.

Fischer RL, Austin JD (2008) Cervical length measurement by translabial sonography in women with preterm premature rupture of membranes: can it be used to predict the latency period or peripartum maternal infection? J Matern Neonatal Med 21:105–109. https://doi.org/10.1080/14767050701866955 CrossRef

18.

Mehra S, Amon E, Hopkins S, Gavard JA, Shyken J (2015) Transvaginal cervical length and amniotic fluid index: Can it predict delivery latency following preterm premature rupture of membranes? Am J Obstet Gynecol 212:400.e-400.e9. https://doi.org/10.1016/j.ajog.2015.01.022 CrossRef

19.

Phupong V, Kulmala L (2015) Factors associated with latency period in preterm prelabor rupture of membranes. J Matern Neonatal Med. https://doi.org/10.3109/14767058.2015.1095884 CrossRef

20.

Yw W, Colford JMJ (2000) Chorioamnionitis as a risk factor for cerebral palsy: a meta-analysis. JAMA 284:1417–1424. https://doi.org/10.1097/00006254-200105000-00004 CrossRef

21.

Wu YW (2002) Systematic review of chorioamnionitis and cerebral palsy. Ment Retard Dev Disabil Res Rev 8:25–29. https://doi.org/10.1002/mrdd.10003 CrossRefPubMed

22.

Yoon BH, Park C-W, Chaiworapongsa T (2003) Intrauterine infection and the development of cerebral palsy. BJOG 110(Suppl):124–127. https://doi.org/10.1016/S1470-0328(03)00063-6 CrossRefPubMed

23.

Shatrov JG, Birch SCM, Lam LT, Quinlivan JA, McIntyre S, Mendz GL (2010) Chorioamnionitis and cerebral palsy. Obstet Gynecol 116:387–392. https://doi.org/10.1097/AOG.0b013e3181e90046 CrossRefPubMed

24.

Shi Z, Ma L, Luo K, Bajaj M, Chawla S, Natarajan G et al (2017) Chorioamnionitis in the development of cerebral palsy: a meta-analysis and systematic review. Pediatrics 139:e20163781. https://doi.org/10.1542/peds.2016-3781 CrossRefPubMedPubMedCentral

25.

Kuba K, Bernstein PS (2018) ACOG practice bulletin no. 188: Prelabor rupture of membranes. Obstet Gynecol 131:1163–1164. https://doi.org/10.1097/AOG.0000000000002663 CrossRefPubMed

26.

Caughey AB, Robinson JN, Norwitz ER (2008) Contemporary diagnosis and management of preterm premature rupture of membranes. Rev Obstet Gynecol 1:11–22PubMedPubMedCentral

27.

American College of Obstetricians and Gynecologists A (2007) ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 109:1007–1019. https://doi.org/10.1097/01.AOG.0000263888.69178.1f

28.

Dagklis T, Petousis S, Margioula-Siarkou C, Mavromatidis G, Kalogiannidis I, Prapas N et al (2013) Parameters affecting latency period in PPROM cases: a 10-year experience of a single institution. J Matern Fetal Neonatal Med 26:1455–1458. https://doi.org/10.3109/14767058.2013.784257 CrossRefPubMed

29.

Yoon BH, Romero R, Park JS, Kim CJ, Kim SH, Choi JH et al (2000) Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years. Am J Obstet Gynecol 182:675–681. https://doi.org/10.1067/mob.2000.104207 CrossRefPubMed

30.

Vigneswaran R (2000) Infection and preterm birth: Evidence of a common causal relationship with bronchopulmonary dysplasia and cerebral palsy. J Paediatr Child Health 36:293–296. https://doi.org/10.1046/j.1440-1754.2000.00536.x CrossRefPubMed

31.

Watterberg KL, Demers LM, Scott SM, Murphy S (1996) Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops. Pediatrics 97:210–215PubMed

32.

Ramsey PS, Lieman JM, Brumfield CG, Carlo W (2005) Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol 192:1162–1166. https://doi.org/10.1016/j.ajog.2004.11.035 CrossRefPubMed

33.

Diebel ND, Parsons MT, Spellacy WN (1998) The effects of betamethasone on white blood cells during pregnancy with PPROM. J Perinat Med 26:204–207. https://doi.org/10.1515/jpme.1998.26.3.204 CrossRefPubMed

34.

Goldshtein I, Neeman U, Chodick G, Shalev V (2010) Variations in hemoglobin before colorectal cancer diagnosis. Eur J Cancer Prev 19:342–344. https://doi.org/10.1097/CEJ.0b013e32833c1be0 CrossRefPubMed

35.

Santillan A, Garg R, Zahurak ML, Gardner GJ, Giuntoli RL, Armstrong DK et al (2005) Risk of epithelial ovarian cancer recurrence in patients with rising serum CA-125 levels within the normal range. J Clin Oncol 23:9338–9343. https://doi.org/10.1200/JCO.2005.02.2582 CrossRefPubMed

Title: Can we predict preterm delivery in patients with premature rupture of membranes?
Authors: Yael Yagur
Omer Weitzner
Eyal Ravid
Tal Biron-Shental
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Premature Rupture of Membranes
Premature Birth
Published in: Archives of Gynecology and Obstetrics / Issue 3/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05196-8

At a glance: The STEP trials

Springer Medicine

Can we predict preterm delivery in patients with premature rupture of membranes?

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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