Can we predict preterm delivery in patients with premature rupture of membranes?
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To characterize the parameters that predict preterm delivery in patients with preterm, premature rupture of membranes.
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.
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).
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.
KeywordsInfection Latency period Preterm birth Preterm Premature rupture of membranes
YY: Project development, Data Collection, management and analysis, Manuscript writing. OW: Project development, Data collection, management and analysis. ER: Data collection. TB-S: Conceptualized the project, Data analysis Manuscript editing.
This study was not funded.
Compliance with ethical standards
Conflict of interest
Yael Yagur declares that she has no conflict of interest. Omer Weitzner declares that he has no conflict of interest. Eyal Ravid declares that he has no conflict of interest. Tal Biron-Shental declares that she has no conflict of interest.
All procedures performed in studies involving human participants were approved by the local institutional ethics committee—The Meir Medical Center Helsinki committee, and are in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Due to retrospective study design, consent for participation was not required.
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