Neonatal outcomes after prelabour rupture of membranes before 24 weeks' gestation

McLaughlin, Linda M; Gardener, Glenn

doi:10.1111/jpc.13210

Cited by 8 publications

(10 citation statements)

References 25 publications

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“…Of these, 38 were selected for full text article review. Finally, 18 articles [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] were included in the review. Figure 1 shows the whole process of study selection, using PRISMA flow diagram [26].…”

Section: Resultsmentioning

confidence: 99%

Perinatal Outcomes of Pre-viable Preterm Premature Rupture of Membranes

Mukhtar¹

2018

J Gyn Obs Bul

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Objective: To assess the maternal and neonatal outcomes after expectant management of pre-viable preterm premature rupture of membranes (PPROM). Data Sources:We searched PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science databases for publications from 2008 to 2018 and ClinicalTrials.gov. Methods of Study Selection:All studies that reported pregnancy outcomes of pre-viable PPROM were included. Excluded were the review articles, case reports, and studies that exclusively included patients with a particular characteristic (oligohydramnios/prolonged latency), those evaluating the effect of a specific intervention, or the ones providing aggregate data from which information for patients with PPROM <24 weeks could not be delineated.Tabulation, Integration, and Results: Eighteen studies were reviewed that examined the outcomes of 1,372 pre-viable PPROM women following expectant management. Data was extracted in the form of predesigned tables. We used Microsoft Excel to integrate the results of included studies. The overall neonatal survival to discharge was 41.5%. Of these, 48.8% neonates survived without a major morbidity. Respiratory morbidity was the most common morbidity among surviving neonates: 49.5% neonates suffered from respiratory distress syndrome, 30% from bronchopulmonary dysplasia, and 10.7% from pulmonary hypoplasia. Chorioamnionitis was the most frequently observed maternal morbidity, complicating 49.3% pre-viable PPROM. The predictors for favorable outcomes included a later gestational age at PPROM and delivery, absence of oligohydramnios, and iatrogenic PPROM. Of note, 21.6% of pre-viable PPROM women opted for the termination of pregnancy. Conclusion:The neonatal survival rate of pre-viable PPROM after expectant management is 4 of 10 affected neonates, and nearly half of them survive without any major morbidity. Maternal morbidity remains substantial, however, serious maternal complications are rare.

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Section: Resultsmentioning

confidence: 99%

Perinatal Outcomes of Pre-viable Preterm Premature Rupture of Membranes

Mukhtar¹

2018

J Gyn Obs Bul

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“…Meanwhile, risk factors for neonatal BPD during pregnancy include intrauterine growth restriction and chorioamnionitis [ 24 ]. One study reported that the incidence rate of BPD was higher in cases who experienced pPROM before 31 weeks of gestation than those who did not experience the condition [ 27 ], Another study reported that from among 36 neonates who were born to mothers diagnosed with pPROM before 24 weeks of gestation and who were discharged following delivery, 17 (47%) developed BPD [ 28 ]. Oligohydramnios was found to be a risk factor for BPD.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for neonatal bronchopulmonary dysplasia in extremely preterm premature rupture of membranes: a retrospective study

Nakamura

Matsunaga

Ono

2020

BMC Pregnancy Childbirth

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Background Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD. Methods This study included 73 subjects with singleton pregnancy, diagnosed with pPROM during the gestational period from 22 weeks and 0 days to 27 weeks and 6 days. The following factors were retrospectively examined: the gestational week at which pPROM was diagnosed, the gestational week at which delivery occurred, the period for which the volume of amniotic fluid was maintained, and neonatal BPD as a complication. Receiver operating characteristic (ROC) curve analyses were conducted to analyse the relationship of the onset of BPD with the duration of oligohydramnios and the gestational weeks of delivery. Results The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5 ± 1.9 weeks (mean ± SD), and that at which delivery occurred was 27.0 ± 3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4 ± 20.5 days. The mean birth weight of neonates was 1000 ± 455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. The ROC curve indicated that the cut-off values for the duration of oligohydramnios and gestational age at delivery were 4 days and 24.1 weeks, respectively. Multivariate analysis indicated that the duration of oligohydramnios for more than 4 days before delivery and preterm delivery at less than 24.1 weeks were risk factors for the onset of BPD. Conclusions Our findings suggest that duration of oligohydramnios for more than 4 days before delivery and preterm delivery less than 24.1 weeks are risk factors for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

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“…Meanwhile, risk factors for neonatal BPD during pregnancy include intrauterine growth restriction and chorioamnionitis (21). One study reported that the incidence rate of BPD was higher in cases who experienced pPROM before 31 weeks of gestation than those who did not experience the condition (24), Another study reported that from among 36 neonates who were born to mothers diagnosed with pPROM before 24 weeks of gestation and who were discharged following delivery, 17 (47%) developed BPD (25).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

Nakamura¹,

Matsunaga²,

Ono³

et al. 2020

Preprint

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Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of singleton pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.Conclusion: Our findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

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Neonatal outcomes after prelabour rupture of membranes before 24 weeks' gestation

Abstract: Almost one-third of pregnancies complicated by PROM before 24 weeks resulted in pre-viable preterm delivery. In pregnancies continuing to a viable gestation, there remained a significant risk of neonatal mortality and morbidity, primarily due to respiratory disease.

Cited by 8 publications

References 25 publications

Perinatal Outcomes of Pre-viable Preterm Premature Rupture of Membranes

Perinatal Outcomes of Pre-viable Preterm Premature Rupture of Membranes

Risk factors for neonatal bronchopulmonary dysplasia in extremely preterm premature rupture of membranes: a retrospective study

Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

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