Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

Abstract

ObjectiveTo determine the association between the presence of oligohydramnios, determined as an amniotic fluid index ≤ 5 cm and the intra-amniotic inflammatory response, fetal inflammatory response and neonatal outcomes in actively managed preterm prelabor rupture of membranes (PPROM).MethodsWomen with singleton pregnancies complicated by PPROM at a gestational age of between 24+0 and 36+6 weeks were included in the study. Ultrasound assessments of the amniotic fluid index and evaluation of the amniotic fluid interleukin (IL)-6 levels were performed at admission. The umbilical cord blood IL-6 levels were evaluated after delivery.ResultsIn total, 74 women were included. The women with oligohydramnios did not have different amniotic fluid IL-6 levels [with oligohydramnios: median 342 pg/mL, interquartile range (IQR) 110-1809 vs. without oligohydramnios: median 256 pg/mL, IQR 122–748; p = 0.71] or umbilical cord blood IL-6 levels (with oligohydramnios: median 8.2 pg/mL, IQR 3.8–146.9 vs. without oligohydramnios: median 5.9 pg/mL, IQR 2.1–27.9; p = 0.14) than those without oligohydramnios. No association between oligohydramnios and neonatal morbidity was found. A correlation between the amniotic fluid index and the interval from rupture of membranes to amniocentesis was observed (rho = −0.34; p = 0.003).ConclusionThe presence of oligohydramnios is not associated with an adverse outcome in actively managed PPROM in singleton pregnancies in the absence of other complications.

Maternal and Perinatal Outcomes in Pregnancies after Preterm Premature Rupture of Membranes Determined by Single Deepest Vertical Pocket

“…Our data indicated that oligohydramnios was associated with an earlier gestational age at PPROM. This finding is in disagreement with data published by most of the authors [1,[8][9][10]12] and we believe that this association is the result of gestational age itself rather than a smaller single deepest vertical pocket.…”

“…This finding is consistent with studies of Borna et al [9], Kurdoglu et al [8] and Kacerovsky et al [10] and in contrast to results published by Mercer et al [6], Vermillion et al [3] and Piazze et al [12]. Interestingly, a study by Abbasalidadeh et al [11] showed a longer latent phase with SDP <2cm when compared to cases with a normal SDP.…”

“…The concept that oligohydramnios is associated with adverse outcomes is not new, however, results from previous studies have been conflicting and contradictory [1][2][3][4][5][6][7][8][9][10][11][12][13]. Our data indicated that oligohydramnios was associated with an earlier gestational age at PPROM.…”

“…Low residual amniotic fluid after PPROM has been associated with complications such as short latency period, chorioamnionitis, neonatal sepsis, respiratory distress syndrome, low Apgar scores, cesarean deliveries, and neonatal death [1][2][3][4][5][6][7][8][9][10][11][12][13].…”

“…The majority of studies in the current literature use AFI to determine the perinatal outcomes of oligohydramnios secondary to PPROM [1][2][3][4][5][6][7][8][9][10][11][12][13]. Only two studies [6,7] were identified that assessed perinatal outcomes after PPROM using the SDP and both of these studies were noted to have conflicting results.…”