Fetal and Maternal Outcome in Preterm Premature Rupture of Membranes (PPROM) at Ain Shams Maternity Hospital: A Retrospective Analysis of Last Five Years Admissions

Abstract

Background PPROM is defined as spontaneous rupture of the membranes before the onset of labour prior to 37 weeks gestation. It complicates 2-4% of all singletons and 7-20% of twin pregnancies and is associated with over 60% of preterm births. Aim of the Work to retrospectively compare the neonatal and maternal outcomes in women with preterm prelabor rupture of the membranes (PPROM) who delivered before versus who delivered after 34 weeks of gestation over a 5-year period (between January 2011 and December 2015). Patients and Methods This retrospective case-control study was conducted at Ain Shams University Maternity Hospital. The analysis covered the period between January 2011 and December 2015. The study included all women admitted to Ain Shams University Maternity Hospital during the period between January 2011 and December 2015 with a diagnosis of preterm prelabor rupture of the membranes (PPROM). Results The incidence of chorioamnionitis (p-value <0.001) and maternal sepsis (p-value = 0.001) were both significantly higher in those delivering before 34 weeks. The gestational age at ROM was significantly lower and the latent period was significantly shorter in patients delivering before 34 weeks of gestation (p-values <0.001). The Apgar score at 1 and 5 minutes as well as the birth weight were significantly lower in the group delivering before 34 weeks of gestation (p-values <0.001). The incidence of low Apgar score at 1 and 5 minutes (p-value <0.001 and 0.002, respectively), NEC (p-value = 0.006), IVH (p-value <0.001), RDS (p-value = 0.005) and neonatal death (p-value <0.001) were all significantly higher in patients delivering before 34 weeks of gestation. Conclusion In women with premature preterm rupture of membrane neonatal and maternal outcomes is better in those who delivered after 34 weeks of gestation when compared to those who delivered before 34 weeks of gestation.

The Role of Platelet Count and Mean Platelet Volume During First Trimester in Prediction of Preterm Premature Rupture of Membranes

“…The study by Nageeb et al (2020) which supports our results found that the gestational age at ROM was significantly lower and the latent period was significantly shorter in patients delivering before 34 weeks of gestation (p-values <0.001).…”

“…Our study showed that birth weight and APGAR score were significantly lower among PPROM cases and NICU also baby mortality were significantly associated with PPROM. The study by Nageeb et al (2020) found that The Apgar score at 1 and 5 minutes as well as the birth weight were significantly lower in the group delivering before 34 weeks of gestation (p-values <0.001).…”

“…Overproduction of cytokines, such as interleukin (IL)-4, IL-6 and tumor necrosis factor, influence platelet characteristics by interfering with megakaryopoiesis and subsequent release of predominantly small platelets from the bone marrow. Another evidence was about thrombopoietin, which is the major hormone that regulates platelet production by acting at earlier stages of megakaryopoiesis (Nageeb et al, 2020).…”