Use of Antenatal Corticosteroids in Preterm Prelabor Rupture of Membranes

Battarbee, Ashley N.

doi:10.1016/j.ogc.2020.08.004

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…The observed variation in administration and timing of antenatal corticosteroids, as well as usage of tocolytics, amongst expectantly managed cases underscores the considerable variability between healthcare providers in the management of pPPROM, and is consistent with other reported literature. 13 , 14 , 20 , 21 While most cases of PPROM would be administered steroids at the time of presentation to hospital with membrane rupture, only one-third of patients with pPPROM in our study received steroids prior to delivery. Acknowledging the inherent challenges of optimal timing of antenatal corticosteroid administration within 1–7 days of preterm delivery, most cases of PPROM are associated with a risk of “stale” steroids (given more than 7 days prior to delivery) as opposed to non-receipt.…”

Section: Discussionmentioning

confidence: 88%

“…Acknowledging the inherent challenges of optimal timing of antenatal corticosteroid administration within 1–7 days of preterm delivery, most cases of PPROM are associated with a risk of “stale” steroids (given more than 7 days prior to delivery) as opposed to non-receipt. 21–23 This study raises awareness of the variation that exists regarding treatment of pregnancies complicated by pPPROM and the need for future interventional controlled trials to evaluate the optimal management of these pregnancies, including mode and timing of delivery; the potential role of amnioinfusion for improving outcomes specifically in the setting of pPPROM also needs to be explored. 24 , 25 …”

Section: Discussionmentioning

confidence: 99%

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Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

Pylypjuk¹,

Majeau²

2021

IJWH

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Purpose To determine perinatal outcomes and influence of amniotic fluid volume in pregnancies complicated by previable, preterm prelabor rupture of membranes (pPPROM). Patients and methods This was a historical cohort study from two tertiary-level maternity hospitals (January 1, 2009 to December 31, 2015). All pregnancies complicated by pPPROM were identified using ICD coding of discharge abstracts. Hospital charts were reviewed to collect maternal demographics, pregnancy and delivery events, and immediate postnatal outcomes (including survival). Post-processing review of stored ultrasound images was performed to evaluate the relationship between amniotic fluid volume and outcomes. Results A total of 113 pregnancies were eligible and 99 were included in the final analysis (74 with “expectant management” and 25 opting for elective termination). The median gestational age at pPPROM was 20+6 weeks [IQR 19+4 to 21+5]. For those choosing expectant management, the median latency between pPPROM and delivery was 7 days, median gestational at delivery was 23+1 weeks, and neonatal survival to discharge was 27.5% overall. There was a trend towards higher rates of pregnancy termination at one hospital (31.7%) compared to the other (15.4%), but no difference between sites with respect to latency, mode of delivery, or survival amongst those managed expectantly. There was a relationship between survival and gestational age at pPPROM ( p <0.04), as well as initial amniotic fluid volume category: 52.6% of survivors had normal initial amniotic fluid volumes whereas the majority of previable losses had oligohydramnios and the majority of stillbirths had anhydramnios. Conclusion After expectant management, more than one in four newborns following pPPROM survived to hospital discharge. While gestational age at rupture was most strongly correlated with survival, normal initial amniotic fluid volumes were mostly seen in survivors whereas stillbirths more frequently had anhydramnios. These findings will help to improve counseling and care of patients with pPPROM and in guiding long-term follow-up studies.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

Pylypjuk¹,

Majeau²

2021

IJWH

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“…Fetal chorioamniotic membranes prematurely rupture before labor even begins (1) . Three percent of pregnancies result in premature rupture of the membranes (PROM), which causes around one-third of all preterm deliveries.…”

Section: Introductionmentioning

confidence: 99%

Fetal-Maternal Morbidity and Mortality as Outcome of Premature Rupture of Membrane (PROM)

El-Mazzally¹,

El-Mazzally²

2023

The Egyptian Journal of Hospital Medicine

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Background: The risk of prenatal morbidity and death associated with PPROM is more than 20%, and the outcome is significantly impacted by the gestational age at delivery. Objectives: The goal of the study was to determine the fetal/maternal outcomes for pregnant patients at Al-Azhar University Hospitals in Cairo who had PPROM as well as any possible risk factors for adverse fetal/neonatal outcomes. Patients and Method: At the Al-Azhar University Hospitals in Cairo, cross-sectional research including 48 women with PROM was done. The trial was from February 2022 to August 2022. All patients were received a thorough history, a general examination, and laboratory tests. Results: In terms of fetal result, 56.3% of infants experienced poor outcomes, such as fetal death and ICU admission, compared to 43.7% of infants who experienced positive outcomes (alive & well).The multivariate analysis revealed that later gestational age at PPROM (OR 0.7 CI 0.22 -0.91) and gush type of PPROM (OR 1.6 CI 1.2 -3.2), history of chorioamnionitis (OR 17.5 CI 13.9 -129.7), delivery by CS (OR 3 CI 2.45 -4.6), and women employment (OR 1.7 CI 1.3 -3.3) were significant independent. Conclusion: PPROM necessitates adequate prenatal care and therapy since it is linked to fetal/maternal morbidity and death.

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“…Additionally, treatment with glucocorticoids in such pregnancies can reduce neonatal mortality and morbidity due to reducing the risk for intraventricular hemorrhage, necrotizing enterocolitis, decrease the need for intensive care unit cares, and increase the risk of sepsis in the rst 48 hours of neonatal life (6-8). Human studies have also shown that betamethasone used during pregnancy can potentially affect placental function, fetal growth, hypothalamic-pituitary-adrenal axis development, and endocrine stress responses during infancy (9)(10)(11)(12). In the fetal period, prenatal use of betamethasone in pregnant women whose fetuses are stunted has resulted in a transient improvement in blood ow to the uterus and umbilical arteries (13).…”

Section: Introductionmentioning

confidence: 99%

The effects of betamethasone on clinical outcome of the late preterm neonates born between 34 and 36 weeks of gestation

Arimi

Zamani

Shariat

et al. 2021

Preprint

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Background: Prenatal corticosteroid administration in preterm labor is one of the most important treatments available to improve neonatal outcomes; however its beneficial effects on late preterm infants (after the 34th week of gestation) remained unknown. We aimed to assess the effects of betamethasone on the clinical condition of the late preterm infants born between 34 and 36 weeks of gestation. Methods: This retrospective cohort study was performed on 100 consecutive infants born between 34 and 36 weeks of gestation and received betamethasone before delivery as the cases and 100 neonates with the same delivery conditions but without receiving betamethasone. All neonates were followed up within hospitalization to assess the neonatal outcome. Results: The neonates receiving betamethasone suffered more from respiratory distress syndrome (49% versus 31%, p = 0.008) and requiring more respiratory support (71% versus 50%, p = 0.002) as compared to the control group. There was no difference between the two groups in other neonatal adverse events or death. Conclusion: the use of betamethasone in the late preterm period (after 34 weeks of gestation) has no beneficial effects on lung maturity or preventing neonatal adverse outcomes, even may lead to increase the risk for RDS and requiring respiratory support.

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Use of Antenatal Corticosteroids in Preterm Prelabor Rupture of Membranes

Cited by 6 publications

References 19 publications

Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

Perinatal Outcomes and Influence of Amniotic Fluid Volume Following Previable, Preterm Prelabor Rupture of Membranes (pPPROM): A Historical Cohort Study

Fetal-Maternal Morbidity and Mortality as Outcome of Premature Rupture of Membrane (PROM)

The effects of betamethasone on clinical outcome of the late preterm neonates born between 34 and 36 weeks of gestation

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