Masatoshi Esaki1, Yoshiaki Maseki1, Atsuko Tezuka1, Madoka Furuhashi2. 1. Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan. 2. Department of Obstetrics, Nagara Medical Center, Gifu, Japan.
Abstract
Objective: To elucidate the efficacy of continuous amnioinfusion on perinatal outcome in women with preterm premature rupture of membranes (PPROM) at periviable gestational ages. Methods: A database was reviewed to identify women with singleton pregnancies who were admitted to the Japanese Red Cross Nagoya Daiichi Hospital due to PPROM before 26 + 0-week gestation between July 2009 and July 2017. Results: A total of 81 women met the criteria for inclusion in this study including 70 and 11 women with and without amnioinfusion, respectively. The latency period between PPROM and delivery was significantly longer in women who underwent amnioinfusion compared with women without amnioinfusion (median: 13 versus 4 days, p < .001). In the survival analysis, the number of women who remained undelivered was significantly higher in the amnioinfusion group than in the non-amnioinfusion group for each gestational age after PPROM (p < .001). Cox's proportional hazards analysis with stepwise backward selection showed that both white blood cell counts on admission and amnioinfusion finally remained as variables that affected the time interval between PPROM and delivery [hazard ratio (95% confidence interval): 1.12 (1.06-1.18) and 0.34 (0.12-0.98), respectively].Conclusions: Continuous amnioinfusion in women with PPROM at periviable gestational ages resulted in significant prolongation of pregnancy and may help improve neonatal outcomes.
Objective: To elucidate the efficacy of continuous amnioinfusion on perinatal outcome in women with preterm premature rupture of membranes (PPROM) at periviable gestational ages. Methods: A database was reviewed to identify women with singleton pregnancies who were admitted to the Japanese Red Cross Nagoya Daiichi Hospital due to PPROM before 26 + 0-week gestation between July 2009 and July 2017. Results: A total of 81 women met the criteria for inclusion in this study including 70 and 11 women with and without amnioinfusion, respectively. The latency period between PPROM and delivery was significantly longer in women who underwent amnioinfusion compared with women without amnioinfusion (median: 13 versus 4 days, p < .001). In the survival analysis, the number of women who remained undelivered was significantly higher in the amnioinfusion group than in the non-amnioinfusion group for each gestational age after PPROM (p < .001). Cox's proportional hazards analysis with stepwise backward selection showed that both white blood cell counts on admission and amnioinfusion finally remained as variables that affected the time interval between PPROM and delivery [hazard ratio (95% confidence interval): 1.12 (1.06-1.18) and 0.34 (0.12-0.98), respectively].Conclusions: Continuous amnioinfusion in women with PPROM at periviable gestational ages resulted in significant prolongation of pregnancy and may help improve neonatal outcomes.
Entities:
Keywords:
Amnioinfusion; PPROM; midtrimester; perinatal outcome; periviable gestational age
Authors: Michael Tchirikov; Ronja Ocker; Gregor Seliger; Katarina Chaoui; Stefan Moritz; Roland Haase Journal: Arch Gynecol Obstet Date: 2021-11-18 Impact factor: 2.493