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Prelabor Rupture Of Membranes At Or Near Term
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Prelabor rupture of membranes is rupture of fetal membranes prior to the onset of labor [1]. Preterm prelabor rupture of membranes (PPROM) is prelabor rupture of fetal membranes ≤37 weeks [1]. This chapter includes guidance for late-preterm (340/7–366/7 weeks), as well as term (≥37 weeks) prerupture of membranes (PROM). For PPROM <34 weeks, see Chap. 20.
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Premature rupture of membranes (PROM) is the leak of amniotic fluid prior to the onset of labour. Differential diagnoses include urinary incontinence and mucous plug. The risks associated with PROM include:Intrauterine infection: monitor closely for maternal pyrexia, fetal tachycardia, foul-smelling or purulent amniotic fluid. Do not give tocolytics if an infection is suspected.Cord ProlapsePreterm birth if PROM < 37 weeks gestation (PPROM)
Prelabor rupture of the membranes
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Roberto Romero, Lami Yeo, Francesca Gotsch, Eleazar Soto, Sonia S. Hassan, Juan Pedro Kusanovic, Ray Bahado-Singh
Prelabor rupture of the membranes (PROM) is rupture of the chorioamniotic membranes before the onset of labor (1). The “latency period” is the interval between PROM and the onset of labor. There is no agreement about the length of the interval between the rupture of the membranes and the onset of labor required to diagnose PROM. This period of time has varied between 1 and 12 hours in the literature (2–9). The consequences of PROM depend on gestational age; therefore, this condition has been classified as “preterm PROM” or “term PROM,” depending upon whether the event occurs before or after 37 weeks of gestation (2–12). The term “previable PROM” has been applied to gestations in which this complication occurs before 23 weeks (12), while “preterm PROM remote from term” refers to the time frame between viability and about 32 weeks, and “PROM near term” is that which occurs between 32 and 36 weeks (12).
Mean Platelet Volume and Mean Platelet Volume/Platelet Count Ratio Are Predictors of Late-Onset Sepsis in Preterm Infants: A Case-Control Study
Published in Fetal and Pediatric Pathology, 2023
Ipek Guney Varal, Pelin Dogan, Ezgi Acar Celik, Elif Güler Kazancı
Platelet indices, namely the number and size of platelets and their ratios, give us information about the platelet functions and the inflammatory response that occurs. The role of platelets in inflammation, anti-infection, and immune responses is being increasingly recognized [11,12]. MPV shows us the average size and maturity of circulating platelets. Increased MPV indicates an increased proportion of young platelets in the circulation, because platelets decrease in size as they age. Increased platelet consumption with resultant increased production results in younger larger circulating platelets [13,14]. Based on this, researchers have tried to associate increases in MPV value with many diseases in which inflammation occurs. It has been shown to be predictive in prelabor rupture of membranes or chorioamnionitis in preterm infants [15]. MPV value was studied in infants born with meconium aspiration, in respiratory distress syndrome or in infants with small for gestational age (SGA) [16–18]. In our study, the MPV value of >9.2 fL was the best discriminating cutoff value.
Haemophilus influenzae infections in pregnancy: a retrospective, nested case–control study
Published in Journal of Obstetrics and Gynaecology, 2022
Shani Zilberman-Itskovich, Chen Oren, Ronit Zaidenstein, Yifat Wiener, Tsillia Lazarovitch, Assaf Rokney, Merav Ron, Vered Agmon, Dror Marchaim
Overall, 19 patients with H.influenzae maternal infection were enrolled (Table 1) and matched to 57 control patients. All isolates were NTHi. Biotype III was the predominant strain. Most (89%) H.influenzae infections were diagnosed in the first two trimesters, and three women were conceived while with intra-uterine device (IUD). Invasive H.influenzae bloodstream infections occurred in 63% of case–patients, and 32% of infections were polymicrobial. Of case patients, 14 pregnancies were miscarried (74%). There were two maternal patients (10%) who developed acute respiratory distress syndrome and required invasive mechanical ventilation. Of the five women who entered labour, 60% had premature rupture of membranes (PROM), and 40% required urgent caesarean section. Prematurity occurred in three out of five births (60%), all neonates had low birth weight (median weight of 1200 g), two (40%) needed invasive mechanical ventilation at birth, and three (60%) developed early neonatal sepsis. There were no maternal or neonatal deaths, but in two of the premature neonates, there were severe lifelong sequels.
The vertical dimension of obesity: adverse pregnancy outcomes in the short obese versus tall obese parturient
Published in Journal of Obstetrics and Gynaecology, 2022
Shadan S. Mehraban, Joanna C. Pessolano, Jane M. Ponterio, Katherine Williamson, Anastasiya Holubyeva, Michael Moretti, Nisha Lakhi
The rate of preterm delivery in our study was higher in the short stature cohort. Other studies have also demonstrated that pre-pregnancy obesity has been linked to spontaneous preterm delivery (Kramer et al. 1995; Hendler et al. 2005). Obesity is known to cause an upsurge in pro-inflammatory cytokines via an increased level of adipokines. Through stimulation of prostaglandins and matrix degrading metalloproteins, these proinflammatory cytokines are associated with cervical ripening and may also cause weakening of the membranes and preterm contractions of the myometrium. These factors can likewise lead to premature rupture of membranes (PROM). Cnattingius et al conducted a population-based cohort study in Sweden with live singleton births from 1992 to 2010 that characterised an association of body mass index to rates of preterm delivery (Cnattingius et al. 2013). This study also found that preterm delivery rates were increased among overweight and obese women along with short stature less than 155 cm (Cnattingius et al. 2013).