Accuracy of imaging parameters in the prediction of lethal pulmonary hypoplasia secondary to mid‐trimester prelabor rupture of fetal membranes: a systematic review and meta‐analysis

Teeffelen, Augustinus S.P. van; Heijden, J. Van Der; Oei, S.G.; Porath, Martina; Willekes, Christine; Opmeer, Brent C.; Mol, Ben Willem J.

doi:10.1002/uog.10047

Cited by 42 publications

(18 citation statements)

References 26 publications

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“…Severe pulmonary hypoplasia is one of the main problems related to PPROM with anhydramnion in second trimester. However, the ultrasound diagnosis of lethal pulmonary hypoplasia secondary to mid-trimester PPROM by ultrasound evaluation is still challenging [92].…”

Section: Maternal and Neonatal Outcomesmentioning

confidence: 99%

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Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome

Tchirikov

Schlabritz‐Loutsevitch

Mäher

et al. 2017

Journal of Perinatal Medicine

194

153

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Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long-and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines. Activation of matrix metalloproteinases (MMP) have been implicated in the mechanism of PPROM. The propagation of bacteria is an important contributing factor not only in PPROM, but also in adverse neonatal and maternal outcomes after PPROM. Inflammatory mediators likely play a causative role in both disruption of fetal membrane integrity and activation of uterine contraction. The "classic PPROM" with oligo/anhydramnion is associated with a short latency period and worse neonatal outcome compared to similar gestational aged neonates delivered without antecedent PPROM. The "high PPROM" syndrome is defined as a defect of the chorio-amniotic membranes, which is not located over the internal cervical os. It may be associated with either a normal or reduced amount of amniotic fluid. It may explain why sensitive biochemical tests such as the Amniosure (PAMG-1) or IGFBP-1/alpha fetoprotein test can have a positive result without other signs of overt ROM such as fluid leakage with Valsalva. The membrane defect following fetoscopy also fulfils the criteria for "high PPROM" syndrome. In some cases, the rupture of only one membrane -either the chorionic or amniotic membrane, resulting in "pre-PPROM" could precede "classic PPROM" or "high PPROM". The diagnosis of PPROM is classically established by identification of nitrazine positive, fern positive watery leakage from the cervical canal observed during in specula investigation. Other more recent diagnostic tests include the vaginal swab assay for placental alpha macroglobulin-1 test or AFP and IGFBP1. In some rare cases amniocentesis and infusion of indigo carmine has been used to confirm the diagnosis of PPROM. The management of the PPROM requires balancing the potential neonatal benefits from prolongation of the pregnancy with the risk of intraamniotic infection and its consequences for the mother and infant. Close monitoring for signs of chorioamnionitis (e.g. body temperature, CTG, CRP, leucocytes, IL-6, procalcitonine, amniotic fluid examinations) is necessary to minimize the risk of neonatal and maternal complications. In addition to delayed delivery, broad spectrum antibiotics of penicillin or cephalosporin group and/or macrolide and corticosteroids have been show to improve neonatal outcome [reducing risk of chorioamnionitis (average risk ratio (RR) = 0.66), neonatal infections (RR = 0.67) and abnormal ultrasound scan of neonatal brain (RR = 0.67)]. The positive effect of continuo...

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Section: Maternal and Neonatal Outcomesmentioning

confidence: 99%

“…The authors concluded that the estimated ROC curves for the chest circumference/ abdominal circumference ratio and other parameters showed limited accuracy in the prediction of pulmonary hypoplasia [92].…”

Section: Maternal and Neonatal Outcomesmentioning

confidence: 99%

Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome

Tchirikov

Schlabritz‐Loutsevitch

Mäher

et al. 2017

Journal of Perinatal Medicine

194

153

View full text Add to dashboard Cite

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“…Our study also provides reference ranges from 20 to 36 weeks of menstrual age, whereas Peralta et al 22 evaluated healthy fetuses from 12 to 32 weeks, although there is less clinical applicability in evaluating lung size before 20 weeks. 5,17,30 More recently, Kehl et al 31 reported reference values from a cross-sectional study between 20 and 40 weeks. Interestingly, when we compare our results with those published by Peralta et al, 22 there are substantial differences.…”

Section: Discussionmentioning

confidence: 99%

Reference Ranges for 2‐Dimensional Sonographic Lung Measurements in Healthy Fetuses

Júnior

Sangi‐Haghpeykar

Bussamra

et al. 2014

J of Ultrasound Medicine

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Objectives The purpose of this study was to establish reference ranges for 2‐dimensional sonographic measurements of fetal lungs from longitudinal data. Methods A total of 214 fetal lung measurements were longitudinally evaluated in 62 healthy fetuses between 20 and 36 weeks’ menstrual age. Both right and left lung areas were measured in the heart 4‐chamber view using lung area tracing and axis diameter methods. Multilevel modeling was used to evaluate the expected values and variability with respect to menstrual age and to generate reference ranges for the lung area, lung‐to‐head ratio, quantitative lung index, and observed‐to‐expected lung‐to‐head ratio for both lungs. Results The expected values varied with menstrual age for all parameters. Variance was menstrual age dependent for all parameters except the longest diameter area measurements and their lung‐to‐head ratios. Conclusions Models are presented for expected 2‐dimensional sonographic lung size parameters and their variance as a function of menstrual age. These data have been used to generate age‐specific reference ranges for both measurements and indices.

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“…Even at high-resource settings, rate of perinatal death when PROM occurs prior to week 22 is approximately 58% and is primarily attributed to pulmonary hypoplasia. Alveolar development takes place around 23 weeks of gestation and the rate of perinatal death declines significantly beyond 24 weeks of gestation [27,28], probably as alveolar function becomes mature enough to perform respiration outside the uterus [29,30]. Therefore, age of viability among high-resource settings ranges between 23-24 weeks of gestation.…”

Section: Previable Prelabor Rupture Of Membranementioning

confidence: 99%

“…Pulmonary hypoplasia is the major risk factor of neonatal mortality [80]. The two major determinants of pulmonary hypoplasia are early gestational age of PROM and low residual amniotic fluid [81,82]. Pulmonary hypoplasia is rare if PROM occurs after 23-24 weeks of gestation, which is the critical gestational age for alveolar development [83].…”

Section: Pre-viable Prommentioning

confidence: 99%

Middle-East OBGYN Graduate Education (MOGGE) Foundation Practice Guidelines: Prelabor rupture of membranes; Practice guideline No. 01-O-19

Shazly

Ahmed

Radwan

et al. 2020

Journal of Global Health

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P relabor rupture of membranes (PROM) refers to rupture of membranes prior to the onset of labor. PROM is a common obstetric disorder that may be associated with significant maternal, fetal and neonatal complications. Diagnosis and management of PROM have been thoroughly investigated in the literature. Nevertheless, many decisions are still debatable. Practice in low-resource settings is prone to several challenges including resource, training, and awareness barriers. This article provides review of the literature and analysis of evidence of management of PROM in general, with attention to debates particularly in low-resource settings. INTRODUCTION | KNOWLEDGE Definitions Although the classic term "premature rupture of membranes" has been recently modified to "prelabor rupture of membranes", the abbreviation (PROM) as well as the definition of the condition have not been

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Accuracy of imaging parameters in the prediction of lethal pulmonary hypoplasia secondary to mid‐trimester prelabor rupture of fetal membranes: a systematic review and meta‐analysis

Abstract: In women who have suffered mid-trimester prelabor rupture of membranes (PPROM), prediction of pulmonary

Cited by 42 publications

References 26 publications

Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome

Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome

Reference Ranges for 2‐Dimensional Sonographic Lung Measurements in Healthy Fetuses

Middle-East OBGYN Graduate Education (MOGGE) Foundation Practice Guidelines: Prelabor rupture of membranes; Practice guideline No. 01-O-19

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