Erken Membran Rüptür Olgularında Başvuru Anındaki Klinik ve Laboratuvar Parametreleri ile Gebelik Sonuçları Arasındaki İlişki
Yıl 2024,
Cilt: 5 Sayı: 5, 219 - 229
Ferhat Aslan
,
Bülent Köstü
,
Alev Özer
,
Ugurkan Erkayıran
,
Güven Arslan
Öz
Preterm erken membran rüptürü (PPROM), gebelikte sıklıkla olumsuz maternal ve fetal sonuçlarla ilişkilendirilen önemli bir komplikasyondur. PPROM vakalarında başvuru sırasındaki klinik ve laboratuvar parametreleri ile gebelik sonuçları arasındaki ilişkinin anlaşılması, etkili yönetim ve müdahale için esastır.
Yöntemler
Çalışma PPROM'lu gebelerde başvuru anındaki klinik ve laboratuvar parametreleri ile latent periyod arasındaki ilişkiyi incelemek amacıyla retrospektif olarak yapıldı. Bir üniversite hastanesinin kadın doğum bölümünde 2015-2017 yılları arasında PPROM tanısı alan gebelerin kayıtları incelendi. Hastalar gebelik haftalarına göre gruplandırılarak başvuru sırasındaki klinik parametreler kaydedildi ve latent periyod ile ilişkileri analiz edildi.
Sonuçlar
Çalışmada elde edilen veriler analiz edildiğinde serviks uzunluğunun (p=0,008) ve başvuru anındaki gebelik haftasının latent periyod üzerine etkisi olduğu görüldü (p<0,001). Ancak amniyotik sıvı indeksi, CRP, WBC ve HGB gibi incelenen diğer parametrelerin latent periyod ile istatistiksel olarak anlamlı bir ilişkisi olmadığı görüldü.
Etik Beyan
İlgili makale sorumlu yazarın tezinden üretilmiştir.
Kaynakça
- Saygı A, Keskin U, Kıncı MF, Ulubay M, Karaşahin KE, Yenen MC. Preterm erken membran rüptürünün başarılı yönetimi. Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi). 2016;41(23898):130-1.
- 2. Merenstein GB, Weisman LE. Premature rupture of the membranes: Neonatal consequences. Seminars in Perinatology. 1996;20(5):375-80.
- 3. Celik E, Yildiz AB, Guler Cekic S, Unal C, Ayhan I, Melekoglu R, et al. Amnioinfusion vs. standard management for the second trimester PPROM: a systematic review and meta-analysis of observational studies and RCTs. The Journal of Maternal-Fetal & Neonatal Medicine. 2023;36(2):2230511.
- 4. Ferguson SE, Smith GN, Salenieks ME, Windrim R, Walker MC. Preterm premature rupture of membranes. Nutritional and socioeconomic factors. Obstet Gynecol. 2002;100(6):1250-6.
- 5. Creasy RK, Merkatz IR. Prevention of preterm birth: clinical opinion. Obstet Gynecol. 1990;76(1 Suppl):2s-4s.
- 6. Philipson EH, Hoffman DS, Hansen GO, Ingardia CJ. Preterm premature rupture of membranes: experience with latent periods in excess of seven days. Am J Perinatol. 1994;11(6):416-9.
- 7. Pergialiotis V, Bellos I, Fanaki M, Antsaklis A, Loutradis D, Daskalakis G. The impact of residual oligohydramnios following preterm premature rupture of membranes on adverse pregnancy outcomes: a meta-analysis. American Journal of Obstetrics and Gynecology. 2020;222(6):628-30.
- 8. Phillips A, Pagan M, Smith A, Whitham M, Magann EF. Management and Interventions in Previable and Periviable Preterm Premature Rupture of Membranes: A Review. Obstetrical & Gynecological Survey. 2023;78(11):682-9.
- 9. Ronzoni S, Boucoiran I, Yudin MH, Coolen J, Pylypjuk C, Melamed N, et al. Guideline No. 430: Diagnosis and management of preterm prelabour rupture of membranes. J Obstet Gynaecol Can. 2022;44(11):1193-208.e1.
- 10. Feduniw S, Gaca Z, Malinowska O, Brunets W, Zgliczynska M, Wlodarczyk M, et al. The Management of Pregnancy Complicated with the Previable Preterm and Preterm Premature Rupture of the Membranes: What about a Limit of Neonatal Viability?-A Review. Diagnostics (Basel). 2022;12(8).
- 11. Mercer BM, Crouse DT, Goldenberg RL, Miodovnik M, Mapp DC, Meis PJ, et al. The antibiotic treatment of PPROM study: systemic maternal and fetal markers and perinatal outcomes. Am J Obstet Gynecol. 2012;206(2):145.e1-9.
- 12. Hvilsom GB, Thorsen P, Jeune B, Bakketeig LS. C-reactive protein: a serological marker for preterm delivery? Acta Obstet Gynecol Scand. 2002;81(5):424-9.
- 13. van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2009;147(2):124-9.
- 14. Pandey D, Bhagat S, Vanya V, V S B, Pai M, Kumar P. Leukocyte count on admission as a predictor of clinical outcome in the expectant management for women with preterm prelabor rupture of membranes. Sri Lanka Journal of Obstetrics and Gynaecology. 2012;33.
- 15. Musilova I, Pliskova L, Gerychova R, Janku P, Simetka O, Matlak P, et al. Maternal white blood cell count cannot identify the presence of microbial invasion of the amniotic cavity or intra-amniotic
inflammation in women with preterm prelabor rupture of membranes. PLoS One. 2017;12(12):e0189394.
- 16. Turhan NO, Karabulut A, Adam B. Maternal serum interleukin 6 levels in preterm labor: prediction of admission-to-delivery interval. J Perinat Med. 2000;28(2):133-9.
- 17. Sweed AS, Taema MI, Akkour K, Khaliq S. Prediction of latency period in patients with PPROM by cervical measurements using Transvaginal Ultrasound; A Prospective cohort study. The Egyptian Journal of Fertility of Sterility. 2023;27(3):47-53.
- 18. Hassan S, Romero R, Hendler I, Gomez R, Khalek N, Espinoza J, et al. A sonographic short cervix as the only clinical manifestation of intra-amniotic infection. J Perinat Med. 2006;34(1):13-9.
- 19. Carlan SJ, Richmond LB, O'Brien WF. Randomized trial of endovaginal ultrasound in
preterm premature rupture of membranes. Obstet Gynecol. 1997;89(3):458-61.
- 20. Gopalani S, Krohn M, Meyn L, Hitti J, Crombleholme WR. Contemporary management of preterm premature rupture of membranes: determinants of latency and neonatal outcome. Am J Perinatol. 2004;21(4):183-90.
- 21. Ekin A, Gezer C, Taner CE, Ozeren M. Perinatal outcomes in pregnancies with oligohydramnios after preterm premature rupture of membranes. J Matern Fetal Neonatal Med. 2015;28(16):1918-22.
- 22. Park JS, Yoon BH, Romero R, Moon JB, Oh SY, Kim JC, et al. The relationship between oligohydramnios and the onset of preterm labor in preterm premature rupture of membranes. Am J Obstet Gynecol. 2001;184(3):459-62.
- 23. Piazze J, Anceschi MM, Cerekja A, Brunelli R, Meloni P, Marzano S, et al. Validity of amniotic fluid index in preterm rupture of membranes. J Perinat Med. 2007;35(5):394-8.
Relationship Between Clinical and Laboratory Parameters at Admission and Pregnancy Outcomes in Cases of Preterm Premature Rupture of Membranes
Yıl 2024,
Cilt: 5 Sayı: 5, 219 - 229
Ferhat Aslan
,
Bülent Köstü
,
Alev Özer
,
Ugurkan Erkayıran
,
Güven Arslan
Öz
Abstract
Background: Preterm premature rupture of membranes (PPROM) is a significant complication in pregnancy, often associated with adverse maternal and fetal outcomes. Understanding the relationship between clinical and laboratory parameters at admission and pregnancy outcomes in PPROM cases is essential for effective management and intervention.
Methods
The study was conducted retrospectively to examine the relationship between clinical and laboratory parameters at the time of admission and the latent period in pregnant women with PPROM. Records of pregnant women diagnosed with PPROM between 2015-2017 in the obstetrics department of a university hospital were reviewed. The patients were grouped according to gestational weeks, clinical parameters at admission were recorded, and their relationships with the latent period were analyzed.
Results
When the data obtained in the study were analyzed, it was shown that cervical length (p = 0.008) and the gestational week at the time of admission had an effect on the latent period (p <0.001). However, the other parameters examined, such as amniotic fluid index, CRP, WBC, and HGB, were not found to have a statistically significant relationship with the latent period.
Kaynakça
- Saygı A, Keskin U, Kıncı MF, Ulubay M, Karaşahin KE, Yenen MC. Preterm erken membran rüptürünün başarılı yönetimi. Cukurova Medical Journal (Çukurova Üniversitesi Tıp Fakültesi Dergisi). 2016;41(23898):130-1.
- 2. Merenstein GB, Weisman LE. Premature rupture of the membranes: Neonatal consequences. Seminars in Perinatology. 1996;20(5):375-80.
- 3. Celik E, Yildiz AB, Guler Cekic S, Unal C, Ayhan I, Melekoglu R, et al. Amnioinfusion vs. standard management for the second trimester PPROM: a systematic review and meta-analysis of observational studies and RCTs. The Journal of Maternal-Fetal & Neonatal Medicine. 2023;36(2):2230511.
- 4. Ferguson SE, Smith GN, Salenieks ME, Windrim R, Walker MC. Preterm premature rupture of membranes. Nutritional and socioeconomic factors. Obstet Gynecol. 2002;100(6):1250-6.
- 5. Creasy RK, Merkatz IR. Prevention of preterm birth: clinical opinion. Obstet Gynecol. 1990;76(1 Suppl):2s-4s.
- 6. Philipson EH, Hoffman DS, Hansen GO, Ingardia CJ. Preterm premature rupture of membranes: experience with latent periods in excess of seven days. Am J Perinatol. 1994;11(6):416-9.
- 7. Pergialiotis V, Bellos I, Fanaki M, Antsaklis A, Loutradis D, Daskalakis G. The impact of residual oligohydramnios following preterm premature rupture of membranes on adverse pregnancy outcomes: a meta-analysis. American Journal of Obstetrics and Gynecology. 2020;222(6):628-30.
- 8. Phillips A, Pagan M, Smith A, Whitham M, Magann EF. Management and Interventions in Previable and Periviable Preterm Premature Rupture of Membranes: A Review. Obstetrical & Gynecological Survey. 2023;78(11):682-9.
- 9. Ronzoni S, Boucoiran I, Yudin MH, Coolen J, Pylypjuk C, Melamed N, et al. Guideline No. 430: Diagnosis and management of preterm prelabour rupture of membranes. J Obstet Gynaecol Can. 2022;44(11):1193-208.e1.
- 10. Feduniw S, Gaca Z, Malinowska O, Brunets W, Zgliczynska M, Wlodarczyk M, et al. The Management of Pregnancy Complicated with the Previable Preterm and Preterm Premature Rupture of the Membranes: What about a Limit of Neonatal Viability?-A Review. Diagnostics (Basel). 2022;12(8).
- 11. Mercer BM, Crouse DT, Goldenberg RL, Miodovnik M, Mapp DC, Meis PJ, et al. The antibiotic treatment of PPROM study: systemic maternal and fetal markers and perinatal outcomes. Am J Obstet Gynecol. 2012;206(2):145.e1-9.
- 12. Hvilsom GB, Thorsen P, Jeune B, Bakketeig LS. C-reactive protein: a serological marker for preterm delivery? Acta Obstet Gynecol Scand. 2002;81(5):424-9.
- 13. van de Laar R, van der Ham DP, Oei SG, Willekes C, Weiner CP, Mol BW. Accuracy of C-reactive protein determination in predicting chorioamnionitis and neonatal infection in pregnant women with premature rupture of membranes: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2009;147(2):124-9.
- 14. Pandey D, Bhagat S, Vanya V, V S B, Pai M, Kumar P. Leukocyte count on admission as a predictor of clinical outcome in the expectant management for women with preterm prelabor rupture of membranes. Sri Lanka Journal of Obstetrics and Gynaecology. 2012;33.
- 15. Musilova I, Pliskova L, Gerychova R, Janku P, Simetka O, Matlak P, et al. Maternal white blood cell count cannot identify the presence of microbial invasion of the amniotic cavity or intra-amniotic
inflammation in women with preterm prelabor rupture of membranes. PLoS One. 2017;12(12):e0189394.
- 16. Turhan NO, Karabulut A, Adam B. Maternal serum interleukin 6 levels in preterm labor: prediction of admission-to-delivery interval. J Perinat Med. 2000;28(2):133-9.
- 17. Sweed AS, Taema MI, Akkour K, Khaliq S. Prediction of latency period in patients with PPROM by cervical measurements using Transvaginal Ultrasound; A Prospective cohort study. The Egyptian Journal of Fertility of Sterility. 2023;27(3):47-53.
- 18. Hassan S, Romero R, Hendler I, Gomez R, Khalek N, Espinoza J, et al. A sonographic short cervix as the only clinical manifestation of intra-amniotic infection. J Perinat Med. 2006;34(1):13-9.
- 19. Carlan SJ, Richmond LB, O'Brien WF. Randomized trial of endovaginal ultrasound in
preterm premature rupture of membranes. Obstet Gynecol. 1997;89(3):458-61.
- 20. Gopalani S, Krohn M, Meyn L, Hitti J, Crombleholme WR. Contemporary management of preterm premature rupture of membranes: determinants of latency and neonatal outcome. Am J Perinatol. 2004;21(4):183-90.
- 21. Ekin A, Gezer C, Taner CE, Ozeren M. Perinatal outcomes in pregnancies with oligohydramnios after preterm premature rupture of membranes. J Matern Fetal Neonatal Med. 2015;28(16):1918-22.
- 22. Park JS, Yoon BH, Romero R, Moon JB, Oh SY, Kim JC, et al. The relationship between oligohydramnios and the onset of preterm labor in preterm premature rupture of membranes. Am J Obstet Gynecol. 2001;184(3):459-62.
- 23. Piazze J, Anceschi MM, Cerekja A, Brunelli R, Meloni P, Marzano S, et al. Validity of amniotic fluid index in preterm rupture of membranes. J Perinat Med. 2007;35(5):394-8.