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Previable PPROM

Daphnie Drassinower, Elizabeth Coviello, Helain J Landy, Cynthia Gyamfi-Bannerman, Annette Perez-Delboy, Alexander M Friedman
BACKGROUND: Cerclage placed for a sonographically short cervix has been shown to reduce the risk of preterm delivery in women with a history of prior preterm birth. While short cervix is traditionally placed before viability, the threshold gestational age at which viability is achieved continues to decrease, and, as a result, a larger subset of women may be ineligible to receive this potentially beneficial procedure. OBJECTIVE: To evaluate the association between obstetric outcomes and perioperative complications after placement of an ultrasound-indicated cerclage at periviability compared to placement in the previable period...
November 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
M H Bentsen, E Satrell, H Reigstad, S L Johnsen, M Vollsæter, O D Røksund, G Greve, A Berg, T Markestad, T Halvorsen
OBJECTIVES: Investigate cardiorespiratory outcomes in children surviving previable preterm premature rupture of membranes (PV-PPROM) before 22 weeks' gestational age (GA) with minimum 2 weeks latency. STUDY DESIGN: Single institution, follow-up of retrospectively identified children who were born after PV-PPROM during 2000-2004, and individually matched preterm-born controls. RESULTS: Eleven PV-PPROM and matched control children were included at mean age of 10...
September 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
Winnie Huiyan Sim, Edward Araujo Júnior, Fabricio Da Silva Costa, Penelope Marie Sheehan
AIM: To assess the contemporary maternal and neonatal outcomes following expectant management of preterm premature rupture of membranes (PPROM) prior to 24 weeks' gestation and to identify prognostic indicators of this morbid presentation. METHODS: We performed a systematic review in the Pubmed and EMBASE databases to identify the primary (perinatal mortality, severe neonatal morbidity and serious maternal morbidity) and secondary (neonatal survival and morbidity) outcomes following expectant management of previable PPROM...
January 1, 2017: Journal of Perinatal Medicine
Olivia Myrick, Sarah Dotters-Katz, Matthew Grace, Tracy Manuck, Kim Boggess, William Goodnight
OBJECTIVE: This study aims to determine if antibiotics given for latency to women with twins and previable preterm premature rupture of membranes (PPROM) affect the duration from membrane rupture to delivery. METHODS: A retrospective cohort study of twin pregnancies at a single center from 2000 to 2015 with previable (14 (0/7)-22 (6/7) weeks) PPROM was conducted. Women who were not candidates for expectant management or who elected for immediate delivery were excluded...
July 2016: American Journal of Perinatology Reports
I van der Marel, R de Jonge, J Duvekot, I Reiss, I Brussé
BACKGROUND: To investigate maternal and neonatal outcomes of previable preterm premature rupture of membranes (PPROM) and compare outcome between previable PPROM before and after 20 weeks of pregnancy, with data from one single center. PATIENTS: All women with singleton or twin pregnancies, from 2002 through 2011, who presented with PPROM before 24 weeks of gestation. METHOD: A retrospective cohort study in a university teaching hospital in the Netherlands...
March 2016: Klinische Pädiatrie
Eric A Strand, Bryrony L Dougherty Schaab, Elizabeth S Moore
INTRODUCTION: The objective of this study was to examine maternal and neonatal outcomes for patients with previable and periviable preterm premature rupture of membranes (PPROM) who were expectantly managed. METHODS: Retrospective cohort study of women with PPROM admitted to the hospital between January 1, 2007, and December 31, 2011. Pre- and periviable PPROM was defined as rupture of the amniotic sac between 14 and 23+6 weeks of gestation. RESULTS: Forty-three patients were included in the study with 36 (83...
May 2014: Obstetrics and Gynecology
Zoltan Kozinszky, János Sikovanyecz, Norbert Pásztor
PURPOSE OF REVIEW: Nearly 1% of pregnancies are affected by some type of midtrimester oligohydramnios. Evidence is currently accumulating that suggests the better efficacy of the new therapeutic procedures relative to conventional management. This review summarizes the available evidence. RECENT FINDINGS: The prolongation of the period between the diagnosis of oligohydramnios and delivery following amnioinfusion and amniopatch techniques appears to be strongly associated with the gestational age and whether the situation was based on rupture of the membranes or not...
April 2014: Current Opinion in Obstetrics & Gynecology
Muriel Doret, Régine Cartier, Juliette Miribel, Jérome Massardier, Mona Massoud, Agnès Bordes, Stéphanie Moret, Pascal Gaucherand
OBJECTIVES: Previable premature rupture of the membranes (pPROM), occurring before 24WG, is associated with a 25% neonatal survival rate. This terrible prognosis may lead to elective pregnancy termination on parents' request. Therefore, certain diagnosis is essential but remains difficult in about 10% of patients. Bed-side biochemical tests developed to help in diagnosis had never been evaluated in early pregnancies. This study aimed to evaluate and compare the in vitro sensitivity, detection limit, reaction time and consistency of AmniSure detecting placental alpha microglobulin-1 (PAMG-1) and actim PROM detecting Insulin Growth Factor Binding Protein-1 (IGFBP-1) in amniotic fluid between 15 and 20weeks of gestation (WG)...
December 2013: Clinical Biochemistry
Sirisha Rao Gundabattula, Lakshmi Rathna Marakani, Shashikala Dasari, Kameswari Surampudi, Manjula Pochiraju, Praveen Kumar Nirmalan
AIM: The aim of this study was to evaluate outcome of pregnancies in women with rescue cerclage for cervical insufficiency. MATERIAL AND METHODS: A retrospective study of all women who underwent rescue cerclage between 2002 and 2011 at an advanced tertiary care perinatal institute in India was conducted. Data retrieved from medical records was used to explore potential associations with prolongation of pregnancy beyond 28 weeks. RESULTS: The mean (standard deviation) gestational age at cerclage was 21...
August 2013: Journal of Obstetrics and Gynaecology Research
Jute Richter, Amanda Henry, Greg Ryan, Philip DeKoninck, Liesbeth Lewi, Jan Deprest
OBJECTIVE: This study aimed to analyze success rates and pregnancy outcomes of amniopatch procedures for previable iatrogenic preterm prelabour rupture of the membranes (PPROM) with associated oligohydramnios. METHODS: Retrospective analysis of amniopatch procedures performed at the University Hospitals Leuven, Belgium, and the Mount Sinai Hospital Toronto, Canada. Cases were analyzed overall and in two sub-groups: PPROM after a needle-based procedure (NP group, n = 13) or after fetoscopic intervention (FI group, n = 11)...
April 2013: Prenatal Diagnosis
Hye-Min Kwak, Hyun-Jin Choi, Hyun-Hwa Cha, Hee-Jun Yu, Jee-Hun Lee, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jong-Hwa Kim
OBJECTIVE: We reviewed women with previable spontaneous premature rupture of membranes (sPPROM) in whom an amniopatch was performed and compared their pregnancy outcomes with a conservative management group. METHODS: Amniopatch, an amnioinfusion of autologous platelet concentrate followed by cryoprecipitate, was performed in 7 women with sPPROM diagnosed at 17-23 weeks' gestation, including one twin pregnancy. Three patients had incompetent cervices and the other 4 patients had sPPROM without incompetent cervices...
2013: Fetal Diagnosis and Therapy
Ken Miyazaki, Madoka Furuhashi, Kana Yoshida, Kaoru Ishikawa
OBJECTIVE: To assess the neonatal and maternal outcomes of pregnancy complicated by previable preterm premature rupture of membranes (PPROM). DESIGN: Retrospective study. SETTING: Tertiary referral hospital. Sample. Forty-five women having aggressive intervention with antibiotics, amnioinfusion, cerclage and tocolysis. METHODS: The hospital database between July 2001 and December 2009 was reviewed for women with singleton fetuses and PPROM before 23(+0) weeks of gestation...
August 2012: Acta Obstetricia et Gynecologica Scandinavica
Shera Sugibayashi, Tod Aeby, David Kim, Bliss Kaneshiro
OBJECTIVE: To determine the accuracy of using amniotic fluid arborization to diagnose preterm premature rupture of membranes (PPROM) in the second trimester using specimens collected from the vaginal pool. STUDY DESIGN: Women presenting for pregnancy termination between 14 and 22 weeks' gestation were enrolled. At the time of termination, amniotic fluid samples were collected directly from the amniotic sac and from the vaginal pool, air dried and examined for arborization...
March 2012: Journal of Reproductive Medicine
Ernesto González-Mesa, José A Herrera, Amaya Urgal, Cristina Lazarraga, María J Benítez, Cristina Gómez
PURPOSE: This paper shows temporal trends of latency period and perinatal survival after preterm premature rupture of membranes at or before 28 weeks (very early PPROM). METHODS: We have studied retrospectively medical records of all cases of very early PPROM attended in our Obstetric Department from January 1, 2000 to December 31, 2010. RESULTS: A total of 327 cases of very early PPROM were attended, representing 0.4 % of all deliveries, 3...
August 2012: Archives of Gynecology and Obstetrics
Hen Y Sela, Lynn L Simpson
Preterm premature rupture of membranes (PPROM) is more prevalent in twin gestations and is major contributor to preterm birth. The management of PPROM in twin pregnancies does not differ significantly from that of singletons. In general, antenatal steroids, latency antibiotics, magnesium sulpfate for neuroprotection, and tocolysis are all potential interventions to consider when PPROM complicates a twin gestation. Certain circumstances, such as PPROM following an invasive procedure, at a previable gestational age, or in a monochorionic gestation, warrant special attention as the implications of PPROM and subsequent recommendations for these twin pregnancies may differ...
June 2011: Clinical Obstetrics and Gynecology
H Soylu, A Jefferies, Y Diambomba, R Windrim, P S Shah
OBJECTIVE: To compare composite adverse outcome rate of infants <32 weeks gestational age (GA) who were born after preterm premature rupture of membranes (PPROM) at previable gestation to those born without PPROM. STUDY DESIGN: Retrospective review of prospective collected data for infants discharged between 2004 and 2007 was conducted. Cases were infants with >7 days of PPROM that occurred before 24 weeks. Matched cohort consisted of infants born without PPROM (matched for GA, sex and admission date)...
October 2010: Journal of Perinatology: Official Journal of the California Perinatal Association
Leandro Keselman, Yuri Perlitz, Johnny Younis, Moshe Ben-Ami
The common management in most centers in cases of multiple pregnancies with preterm premature rupture of membranes (PPROM) before 22 weeks of gestation is termination of the pregnancy or the expectant approach. Expectant management of previable PPROM in twin pregnancies results in an increased rate of fetal and neonatal morbidity and mortality of both twins. Selective fetocide of the twin with early midtrimester rupture of membranes may improve the unfavorable pregnancy outcome of the remaining fetus. We report two successful cases of twin pregnancies complicated by extremely PPROM managed by selective fetocide of the affected twin, with an uneventful single pregnancy course and delivery of healthy newborns at 36 weeks of gestation...
March 2008: American Journal of Perinatology
Monique G Lin
Prolapse of the umbilical cord is a rare obstetric emergency that in the viable fetus necessitates an expeditious delivery. A case of a periviable pregnancy complicated by preterm premature rupture of membranes and overt umbilical cord prolapse was prolonged 2 weeks with expectant management is described. An extensive review of the literature regarding the etiology, risk factors, and management options for umbilical cord prolapse in both viable and previable pregnancies accompanies this report.
April 2006: Obstetrical & Gynecological Survey
Lee C Yang, Donald R Taylor, Howard H Kaufman, Roderick Hume, Byron Calhoun
The authors retrospectively evaluated maternal and fetal outcomes of 73 consecutive singleton pregnancies complicated by preterm premature rupture of amniotic membranes. When preterm labor occurred and fetuses were at a viable gestational age, pregnant patients were managed aggressively with tocolytic therapy, antenatal corticosteroid injections, and antenatal fetal testing. The mean gestational age at the onset of membrane rupture and delivery was 22.1 weeks and 23.8 weeks, respectively. The latency from membrane rupture to delivery ranged from 0 to 83 days with a mean of 8...
December 2004: Journal of the American Osteopathic Association
Mara J Dinsmoor, Rebecca Bachman, Elaine I Haney, Marci Goldstein, William Mackendrick
OBJECTIVE: This study was undertaken to assess contemporary outcomes in pregnancies managed expectantly after extremely preterm premature (< or =24 weeks) premature rupture of the membranes (EPPROM). STUDY DESIGN: We queried antepartum and ultrasound databases for patients with EPPROM. Data on pregnancy outcome and short-term neonatal outcomes were collected. RESULTS: Forty-six patients with EPPROM were studied. Patients were hospitalized at 24 weeks' gestation and given antibiotics and antenatal steroids...
January 2004: American Journal of Obstetrics and Gynecology
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