Neonatal and early childhood outcomes following early vs later preterm premature rupture of membranes

Manuck, Tracy A.; Varner, Michael W.

doi:10.1016/j.ajog.2014.05.030

Cited by 68 publications

(55 citation statements)

References 14 publications

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“…Surviving children also have higher risks of physical and developmental disabilities, including chronic respiratory disease, neurodevelopmental or behavioral effects (impairment of visual/hearing/executive functioning, global developmental delay and psychiatric/behavioral sequela) and cardiovascular diseases. Prolonged anhydramnion after PPROM is associated with a four-fold increased risk of composite adverse outcomes, including death, BPD, severe neurological disorders, severe retinopathy, when compared to an age-adjusted control group [7,8].…”

Section: Introductionmentioning

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

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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: Introductionmentioning

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

show abstract

“…Further studies with longer follow up are warranted to confirm or infirm the absence of difference in cognitive deficiencies and learning disabilities at school. Moreover, Manuk showed in a multicenter controlled randomized study that children affected by EPPROM had a poorer outcome at 2 years compared with children affected by PPROM [31]. …”

Section: Discussionmentioning

confidence: 99%

Outcome at Two Years of Very Preterm Infants Born after Rupture of Membranes before Viability

Kieffer¹,

Cardoso²,

Thill³

et al. 2016

PLoS ONE

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PurposeTo compare the respiratory and neurological outcomes at two years of age of preterm children born before 33 weeks of gestation (WG) after early preterm premature rupture of membranes (EPPROM) between 14 and 24 WG with preterm children without EPPROM.Design and PatientsThis single-center case-control retrospective study was conducted at Rouen University Hospital between 1st January 2000 and 31st December 2010. All the cases with EPPROM born from 26WG to 32WG were included. Each newborn was matched by sex, gestational age (GA) and year of birth to two very preterm children, born without EPPROM. At two years of corrected age, motor and cognitive abilities were assessed by routine score based on the Amiel-Tison and Denver developmental scales.ResultsNinety-four cases with EPPROM before 24WG have been included. The 31 children born from 26WG to 32WG were matched with 62 controls. The EPPROM group had poorer clinical evaluation at one year for motor (p = 0.003) and cognitive developmental scores (p = 0.016). Neuromotor rehabilitation was performed more often (p = 0.013). However, there was no difference at 2 years of age. Children born after EPPROM were hospitalized more often for bronchiolitis (p<0.001) during their first 2 years, which correlates with increased incidence of pneumothorax (p = 0.017), pulmonary hypoplasia (p = 0.004) and bronchopulmonary dysplasia (p = 0.005) during neonatal period.ConclusionAt two years, despite an increase in severe bronchiolitis and the need for more neuromotor rehabilitation during the first month of the life after discharge, there was no difference in neurological outcomes in the very preterm children of the EPPROM group compared to those born at a similar GA without EPPROM.

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“…2 PPROM is one of the leading causes of perinatal morbidity and mortality, because it is associated with neonatal infection and umbilical cord compression due to oligohydramnios. [2][3][4] Birth asphyxia (BA) is one of the adverse outcomes occurred due to PPROM that can lead to severe hypoxic ischaemic organ damage in newborns followed by other life-long pathologies.…”

Section: Introductionmentioning

confidence: 99%

Can we predict birth asphyxia of neonates born from PPROM women?

Fattah¹,

Purwosunu

Sungkar

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: To develop a simple and accurate method of predicting birth asphyxia of neonates born from preterm premature rupture of membranes (PPROM) women utilizing clinical parameters that are generally available before delivery in the practical setting.Methods: A retrospective cohort was conducted at single tertiary hospital in Jakarta between January and December 2013. Subjects were PPROM women with singleton live pregnancy who had their delivery on 24 to 34 weeks of gestational age (GA). Primary outcome was birth asphyxia defined by 5th minutes APGAR score < 7. The variables studied were leukocyte counts, gestational age at PPROM, clinical chorioamnitis, severe preeclampsia, mode of delivery, and PPROM-admission duration. Prediction model was developed using logistic regression analysis.Results: One hundred and seventy five out of 380 PPROM women registered in our database met the inclusion criteria. The incidence of BA was 14.29% (25/175). The cutoff value for maternal leukocyte counts and gestational age to predict birth asphyxia was respectively 12,450/mm3 (area under the curve 0.68, 95%CI 0.57-0.80) and 32 weeks (area under the curve 0.81, 95%CI 0.70-0.92). A prediction model was developed consisted of GA at PPROM < 32 weeks of GA (OR=9.58, 95%CI 3.32 – 27.62) and maternal leukocyte counts > 12,450/mm3 (OR=3.6, 95%CI 1.11-11.63), (Final AUC=0.82 (95%CI 0.74-0.89). Clinical chorioamnitis, severe preeclampsia, mode of delivery, PPROM-admission duration was not associated with birth asphyxia.Conclusions: A prediction model to predict BA among PPROM women at 24-34 weeks GA was developed consisted of GA at PPROM and maternal leukocyte counts at patient’s admission.

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Neonatal and early childhood outcomes following early vs later preterm premature rupture of membranes

Cited by 68 publications

References 14 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

Outcome at Two Years of Very Preterm Infants Born after Rupture of Membranes before Viability

Can we predict birth asphyxia of neonates born from PPROM women?

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