Advertisement

Archives of Gynecology and Obstetrics

, Volume 300, Issue 3, pp 615–621 | Cite as

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

  • Yael YagurEmail author
  • Omer Weitzner
  • Eyal Ravid
  • Tal Biron-Shental
Maternal-Fetal Medicine
  • 74 Downloads

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.

Keywords

Infection Latency period Preterm birth Preterm Premature rupture of membranes 

Notes

Author contributions

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.

Funding

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.

Ethical approval

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.

References

  1. 1.
    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 CrossRefGoogle Scholar
  2. 2.
    Waters TP, Mercer B (2011) Preterm PROM: prediction, prevention, principles. Clin Obstet Gynecol 54:307–312.  https://doi.org/10.1097/GRF.0b013e318217d4d3 CrossRefGoogle Scholar
  3. 3.
    Matthews TJ, MacDorman MF (2013) Infant mortality statistics from the 2010 period linked birth/infant death data set. Natl Vital Stat Rep 62:1–26Google Scholar
  4. 4.
    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 Google Scholar
  5. 5.
    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 CrossRefGoogle Scholar
  6. 6.
    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
  7. 7.
    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 CrossRefGoogle Scholar
  8. 8.
    Mercer BM (2003) Preterm premature rupture of the membranes. Obstet Gynecol 101:178–193.  https://doi.org/10.1016/S0029-7844(02)02366-9 Google Scholar
  9. 9.
    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 Google Scholar
  10. 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 CrossRefGoogle Scholar
  11. 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 Google Scholar
  12. 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 CrossRefGoogle Scholar
  13. 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 CrossRefGoogle Scholar
  14. 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 CrossRefGoogle Scholar
  15. 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 CrossRefGoogle Scholar
  16. 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 Google Scholar
  17. 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 CrossRefGoogle Scholar
  18. 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 CrossRefGoogle Scholar
  19. 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 Google Scholar
  20. 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 CrossRefGoogle Scholar
  21. 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 CrossRefGoogle Scholar
  22. 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 CrossRefGoogle Scholar
  23. 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 CrossRefGoogle Scholar
  24. 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 CrossRefGoogle Scholar
  25. 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 CrossRefGoogle Scholar
  26. 26.
    Caughey AB, Robinson JN, Norwitz ER (2008) Contemporary diagnosis and management of preterm premature rupture of membranes. Rev Obstet Gynecol 1:11–22Google Scholar
  27. 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. 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 CrossRefGoogle Scholar
  29. 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 CrossRefGoogle Scholar
  30. 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 CrossRefGoogle Scholar
  31. 31.
    Watterberg KL, Demers LM, Scott SM, Murphy S (1996) Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops. Pediatrics 97:210–215Google Scholar
  32. 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 CrossRefGoogle Scholar
  33. 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 CrossRefGoogle Scholar
  34. 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 CrossRefGoogle Scholar
  35. 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 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyMeir Medical CenterKfar SabaIsrael
  2. 2.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

Personalised recommendations