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Cesarean section does not affect neonatal outcomes of pregnancies complicated with preterm premature rupture of membranes

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Chinese Medical Journal 2020年第1期133卷 25-32页

作者： Hai-Li Jiang Chang Lu Xiao-Xin Wang Xin Wang Wei-Yuan Zhang Department of Obstetrics Beijing Obstetrics and Gynecology HospitalCapital Medical UniversityBeijing 100026China

Background:preterm premature rupture of membranes(PPROM)is associated with high neonatal morbidity and ***,the influences of cesarean section(CS)on neonatal outcomes in preterm pregnancies complicated with PPROM are not well *** aim of this study was to investigate the influence of delivery modes on neonatal outcomes among pregnant women with ***:A retrospective cross-sectional study was conducted in 39 public hospitals in 14 cities in the mainland of China from January 1st,2011 to December 31st,2011.A total of 2756 singleton pregnancies complicated with PPROM were *** neonatal outcomes including early neonatal death,birth asphyxia,respiratory distress syndrome(RDS),pneumonia,infection,birth trauma,and 5-min/10-min Apgar scores were obtained from the hospital *** variables and ordinal variables were respectively calculated by binary logistic regressions and ordinal *** variables were compared by multiple linear ***:In total,2756 newborns were involved in the *** them,1166 newborns(42.31%)were delivered by CS and 1590 newborns belonged to vaginal delivery(VD)*** CS proportion of PPROM obviously increased with the increase of gestational age(x2=5.014,P=0.025).Compared with CS group,VD was associated with a higher risk of total newborns mortality(odds ratio[OR],2.38;95%confidence interval[Cl],1.102-5.118;P=0.027),and a lower level of pneumonia(OR,0.32;95%Cl,0.126-0.811;P=0.016).However,after multivariable adjustment and stratification for gestational age,only pneumonia was significantly related with CS in 28 to 34 weeks group(OR,0.34;95%Cl,0.120-0.940;P=0.038).There were no differences regarding to other adverse outcomes in the two groups,including neonatal mortality,birth asphyxia,Apgar scores,RDS,pneumonia,and ***:The proportion of CS of pregnant women with PPROM was very high in *** mode of delivery does not affect neonatal outcomes of pr

关键词： preterm premature rupture of membranes Cesarean section Vaginal delivery Perinatal outcomes

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A Bayesian Stepwise Discriminant Model for Predicting Risk Factors of preterm premature rupture of membranes： A Case-control Study

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Chinese Medical Journal 2017年第20期130卷 2416-2422页

作者： Li-Xia Zhang Yang Sun Hai Zhao Na Zhu Xing-De Sun Xing Jin Ai-Min Zou Yang Mi Ji-Ru Xu Department of Microbiology and Immunology Health Science Center Xi'an Jiaotong University Xi'an Shaanxi 710061 China Deparment of Clinical Laboratory Shaanxi Provincial People's Hospital Xi'an Shaanxi 710068 China Department of Medical Statistics Shaanxi Provincial People's Hospital Xi'an Shaanxi 710068 China Deparment of Clinical Laboratory Xi'an Fourth Hospital Xi'an Shaanxi 710004 China Deparment of Clinical Laboratory Xi'an Gaoxin Hospital Xi'an Shaanxi 710075 China Deparment of Clinical Laboratory Chang'an Hospital Xi'an Shaanxi 710018 China Department of Obstetrics and Gynecology The Northwest Women and Children Hospital Xi'an Shaanxi 710061 China

Background： preterm premature rapture of membrane （PPROM） can lead to serious consequences such as intrauterine infection, prolapse of the umbilical cord, and neonatal respiratory distress syndrome. Genital infection is a very important risk which closely related with PPROM. The preliminary study only made qualitative research on genital infection, but there was no deep and clear judgment about the effects of pathogenic bacteria. This study was to analyze the association of in fections with PPROM in pregnant women in Shaanxi, China, and to establish Bayesian stepwise discriminant analysis to predict the incidence of PPROM. Methods： In training group, the 112 pregnant women with PPROM were enrolled in the case subgroup, and 108 normal pregnant women in the control subgroup using an unmatched case-control method. The sociodemographic characteristics of these participants were collected by face-to-face interviews. Vaginal excretions fiom each participant were sampled at 28 36-6 weeks of pregnancy using a sterile swab. DNA corresponding to Chlamrdia trachomalix （CT）, Ureaplasma urealyticwn （UU）, Candida albicans, group B streptococci （GBS）, herpes simplex virus- 1 （HSV-1）, and HSV-2 were detected in each participant by real-time polymerase chain reaction. A model of Bayesian discriminant analysis was established and then verified by a mull）center validation group that included 500 participants in the case subgroup and 5（10 participants in the control subgroup from five different hospitals in the Shaanxi province, respectively. Results： The sociological characteristics were not significantly different between the case and control subgroups in both training and validation groups （all P 〉 0.05）. In training group, the infection rates of UU （11.6% vs. 3.7%）, CT （17.0% vs. 5.6%）, and GBS （22.3% vs. 6.5%） showed statistically different between the case and control subgroups （all P 〈 0.05）, Iog-transfomacd quantification of UU, CE GBS, and HSV-2 showed statistically different

关键词： Bayesian Stepwise Discfiminant Analysis EtiologicalFactors Infection preterm premature rupture of membranes

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Lamellar Bodies Count (LBC) as a Predictor of Fetal Lung Maturity in preterm premature rupture of membranes Compared to Neonatal Assessment

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Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1047-1057页

作者： Malames Mahmoud Faisal Noha Hamed Rabei Hoda Ezz El-Arab Abd El-Wahab Abeer Hosny El-Zakkary Department of Obstetrics and Gynecology Faculty of Medicine Ain Shams University Cairo Egypt Department of Clinical Pathology Faculty of Medicine Ain Shams University Cairo Egypt

Background: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality, affecting approximately 1% of all live births and 10% of all preterm infants. Lamellar bodies represent a storage form of pulmonary surfactant within Type II pneumocytes, secretion of which increases with advancing gestational age, thus enabling prediction of the degree of FLM. preterm premature rupture of membranes (PPROM) complicates approximately 1/3 of all preterm births. Birth within 1 week is the most likely outcome for any patient with PPROM in the absence of adjunctive treatments. Respiratory distress has been reported to be the most common complication of preterm birth. Sepsis, intraventricular haemorrhage, and necrotizing enterocolitis also are associated with prematurity, but these are less common near to term. Objective: To assess the efficacy of the amniotic fluid lamellar body counting from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Methods: This study was conducted at Ain Shams University Maternity Hospital in the emergency ward from January 2019 to September 2019. It included 106 women with singleton pregnancies, gestational age from 28 - 36 weeks with preterm premature rupture of membranes. This study is designed to assess the efficacy of the amniotic fluid lamellar body counting (LBC) from a vaginal pool in predicting fetal lung maturity in women with preterm premature rupture of membranes. Results: The current study revealed a highly significant increase in the lamellar body count in cases giving birth to neonates without RDS compared to that cases giving birth to neonates with RDS. Also, no statistically significant difference between LBC and age, parity and number of previous miscarriages in the mother was found. Gestational age at delivery was significantly lower among cases with respiratory distress. Steroid administration was significantly less frequent among cases with respiratory d

关键词： Fetal Lung Maturity Lamellar Bodies Count preterm premature rupture of membranes Respiratory Distress Syndrome

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