Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients
Prelabor preterm rupture of the membranes (PPROM) refers to the rupture of the membranes before 37 weeks, but also before the onset of labor. Approximately 3% of pregnancies are complicated by PPROM, which is an important cause of neonatal morbidity and mortality. The aim of the study is to demonstr...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/1/214 |
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| author | Roxana Elena Bohilțea Ana Maria Cioca Vlad Dima Ioniță Ducu Corina Grigoriu Valentin Varlas Florentina Furtunescu |
| author_facet | Roxana Elena Bohilțea Ana Maria Cioca Vlad Dima Ioniță Ducu Corina Grigoriu Valentin Varlas Florentina Furtunescu |
| author_sort | Roxana Elena Bohilțea |
| collection | DOAJ |
| description | Prelabor preterm rupture of the membranes (PPROM) refers to the rupture of the membranes before 37 weeks, but also before the onset of labor. Approximately 3% of pregnancies are complicated by PPROM, which is an important cause of neonatal morbidity and mortality. The aim of the study is to demonstrate the benefit of expectant management in PPROM, compared to immediate birth, defined in our study as birth in the first 48 h. We analyzed 562 pregnancies with PPROM by gestational age groups and short-term morbidities. Material and methods: We conducted a retrospective observational analytical study, which included women with PPROM between 24 + 0 and 36 + 6 weeks. We divided the cohort into gestational age groups: group 1 gestational age (GA) between 24 and 27, group 2 GA between 28 and 31, group 3 GA between 32 and 34, group 4 GA > 35 weeks. In each group, we analyzed the benefit of the latency period (established in our study as delivery after 48 h of hospitalization) in terms of short-term neonatal complications. Result: The latency period brought a significant benefit starting with GA greater than 28 weeks; therefore, in the group with GA between 28–31, the complications were significantly statistically lower, mentioning respiratory distress syndrome (no latency 100% vs. latency 85.1%) and admission to the neonatal intensive care unit (no latency 89.7% vs. latency 70.2%). In group 3, with GA between 32–34, we reached statistical significance in terms of respiratory distress syndrome (no latency 61.8% vs. latency 39%), hypoxia (no latency 50% vs. latency 31.7%) and admission to the neonatal intensive care unit (no latency 70.2% vs. latency 47.4%). Conclusion: Expectant management of pregnancies with PPROM can bring a real benefit in terms of the incidence of complications in premature infants, but this benefit depends most on the gestational age at which the membranes ruptured and the medical conduct put into practice during the latency period. |
| first_indexed | 2024-03-10T03:36:14Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:36:14Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f9f5b986119f48138912ab2bcd7ae3252023-11-23T11:45:26ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-0111121410.3390/jcm11010214Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 PatientsRoxana Elena Bohilțea0Ana Maria Cioca1Vlad Dima2Ioniță Ducu3Corina Grigoriu4Valentin Varlas5Florentina Furtunescu6Department of Obstetrics, Gynecology and Neonatology, Filantropia Clinical Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, RomaniaDepartment of Obstetrics, Gynecology and Neonatology, Filantropia Clinical Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, University Emergency Hospital, 169 Splaiul Independentei Bld., Sector 5, 050098 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Obstetrics, Gynecology and Neonatology, Filantropia Clinical Hospital, 11–13 Ion Mihalache Blv., Sector 1, 011171 Bucharest, RomaniaDepartment of Public Health and Management, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, RomaniaPrelabor preterm rupture of the membranes (PPROM) refers to the rupture of the membranes before 37 weeks, but also before the onset of labor. Approximately 3% of pregnancies are complicated by PPROM, which is an important cause of neonatal morbidity and mortality. The aim of the study is to demonstrate the benefit of expectant management in PPROM, compared to immediate birth, defined in our study as birth in the first 48 h. We analyzed 562 pregnancies with PPROM by gestational age groups and short-term morbidities. Material and methods: We conducted a retrospective observational analytical study, which included women with PPROM between 24 + 0 and 36 + 6 weeks. We divided the cohort into gestational age groups: group 1 gestational age (GA) between 24 and 27, group 2 GA between 28 and 31, group 3 GA between 32 and 34, group 4 GA > 35 weeks. In each group, we analyzed the benefit of the latency period (established in our study as delivery after 48 h of hospitalization) in terms of short-term neonatal complications. Result: The latency period brought a significant benefit starting with GA greater than 28 weeks; therefore, in the group with GA between 28–31, the complications were significantly statistically lower, mentioning respiratory distress syndrome (no latency 100% vs. latency 85.1%) and admission to the neonatal intensive care unit (no latency 89.7% vs. latency 70.2%). In group 3, with GA between 32–34, we reached statistical significance in terms of respiratory distress syndrome (no latency 61.8% vs. latency 39%), hypoxia (no latency 50% vs. latency 31.7%) and admission to the neonatal intensive care unit (no latency 70.2% vs. latency 47.4%). Conclusion: Expectant management of pregnancies with PPROM can bring a real benefit in terms of the incidence of complications in premature infants, but this benefit depends most on the gestational age at which the membranes ruptured and the medical conduct put into practice during the latency period.https://www.mdpi.com/2077-0383/11/1/214PPROMpremature complicationslatencyexpectant managementcorticosteroidneonatal outcome |
| spellingShingle | Roxana Elena Bohilțea Ana Maria Cioca Vlad Dima Ioniță Ducu Corina Grigoriu Valentin Varlas Florentina Furtunescu Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients Journal of Clinical Medicine PPROM premature complications latency expectant management corticosteroid neonatal outcome |
| title | Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients |
| title_full | Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients |
| title_fullStr | Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients |
| title_full_unstemmed | Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients |
| title_short | Expectant Management of PPROM Improves Neonatal Outcome—A Retrospective Study of 562 Patients |
| title_sort | expectant management of pprom improves neonatal outcome a retrospective study of 562 patients |
| topic | PPROM premature complications latency expectant management corticosteroid neonatal outcome |
| url | https://www.mdpi.com/2077-0383/11/1/214 |
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