Transactions from the 24th Annual Meeting of the American Gynecological and Obstetrical SocietyRisk factors for previable premature rupture of membranes or advanced cervical dilation: A case control study
Section snippets
Methods
A retrospective case control study was performed that compared women with PPROM or ACD to term control subjects. Cases and control subjects were identified from the delivery log book, and charts were reviewed to confirm diagnosis and to collect data. The cases were all singleton pregnancies between 14 weeks 0/7 days and 24 weeks 0/7 days of gestation with PPROM or ACD between January 1, 1996, and December 31, 2000. ACD was defined as membranes bulging to or through the external cervical os
Results
One hundred two women had second trimester PPROM, and 56 women had ACD during the study period. Control subjects were collected in a 2:1 control to total case (PPROM and ACD) ratio and were not matched on any characteristics. Therefore, there were 316 control subjects. The total number of deliveries at the University of Illinois at Chicago, during the study period was 12,674; the prevalences of previable PPROM and ACD were 0.8% and 0.4%, respectively. Interestingly, 23 of the 56 women (41%)
Comment
The rate of mid-trimester PPROM or ACD in our population was 1%, which is relatively high and suggests that this is a very high-risk group of women for early PPROM.1, 2, 12 In a case control study in a high-risk population of inner city women of color, we found that the significant associations with mid-trimester PPROM were similar to those reported associations for later PPROM and included tobacco use and history of previous poor pregnancy outcome.14, 15, 16 The largest associations were with
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Controversies in treatment practices of the mother-infant dyad at the limit of viability
2022, Seminars in PerinatologyCitation Excerpt :Rupture of membranes at the limit of viability is a rare event (<1%).73 The vast majority of periviable PPROM occurs spontaneously, but risk factors include a history of preterm delivery (OR: 15.2; 95% CI 16.1–37.8), cervical incompetence in the current pregnancy (OR, 12.7; 95% CI 3.5–46.4), cerclage (OR, 10.3; 95% CI 2.8–38.8), prior history of PROM (OR, 7.3; 95% CI 2.5–22.3), and tobacco use (OR, 2.0; 95% CI, 1.1–3.9).74 Following multi-disciplinary counseling, the majority of women confronted with PPROM at the limit of viability terminate pregnancy (∼82%).75
Periviable Premature Rupture of Membranes
2020, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :These factors include a history of cervical insufficiency or cerclage, antepartum bleeding, multiple gestations, prior PPROM or preterm labor, tobacco smoking, and amniocentesis.11 Although inflammation from bacterial infection can lead to extracellular matrix weakening, in a review by Kilpatrick and colleagues,12 infection with gonorrhea, chlamydia, or bacterial vaginosis was not associated with PPROM. This suggests that other bacteria play a role in inflammation as evidenced by a higher level of histologic chorioamnionitis13 and fetal inflammatory response syndrome.14
Antenatal management in case of preterm premature rupture of membranes before fetal viability: CNGOF Preterm Premature Rupture of Membranes Guidelines
2018, Gynecologie Obstetrique Fertilite et SenologieGenetics and genomics of preterm birth
2018, Human Reproductive and Prenatal GeneticsManagement and outcomes of pregnancies complicated by preterm premature rupture of membranes before 26 weeks of gestation
2014, Gynecologie Obstetrique et FertiliteInfluence of atmospheric pressure and its variations on premature rupture of membranes
2013, Journal de Gynecologie Obstetrique et Biologie de la Reproduction
Presented at the Twenty-Fourth Annual Meeting of the American Gynecological and Obstetrical Society, September 29-October 1, 2005, Victoria, British Columbia, Canada.
Reprints not available from the authors.