Startseite Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome
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Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome

  • Nicola Volpe ORCID logo , Elvira di Pasquo , Alice Ferretti , Andrea Dall’Asta , Stefania Fieni , Tiziana Frusca und Tullio Ghi EMAIL logo
Veröffentlicht/Copyright: 22. Oktober 2020
Journal of Perinatal Medicine
Aus der Zeitschrift Journal of Perinatal Medicine Band 49 Heft 3

Abstract

Objectives

The early identification of women with preterm premature rupture of membranes (p-PROM) who are at higher risk of imminent delivery remains challenging. The aim of our study was to evaluate if an increased echogenicity of the amniotic membranes may represent a sonographic marker of impending delivery in women with p-PROM.

Methods

This was a prospective study including women with singleton pregnancies and diagnosis of p-PROM between 22 and 37 gestational weeks. A sonographic examination was performed within 24 h from the hospital admission and the appearance of the amniotic membranes close to the internal os was specifically evaluated. The membranes were defined as hyperechoic when their echogenicity was similar to that of the fetal bones or normoechoic in the other cases. The primary aim of the study was to compare the admission to spontaneous onset of labor interval and the pregnancy outcome between the cases of p-PROM with and without hyperechoic membranes.

Results

Overall, 45 women fulfilled the inclusion criteria with similar characteristics at admission. In women with hyperechoic membranes, the admission to spontaneous onset of labor interval was significantly shorter (11.5 [5.3–25.0] vs. 3.0 [1.5–9.0] p=0.04) compared to women with normo-echoic membranes. At binomial logistic regression after adjustment for GA at hospital admission, the presence of hyperechoic membranes was found as the only independent predictor of spontaneous onset of labor ≤72 h (aOR: 6.1; 95% CI: 1.0–36.9)

Conclusions

The presence of hyperechoic membranes is associated with a 6-fold higher incidence of spontaneous onset of labor within 72 h independently from the gestational age at p-PROM.

Keywords: latency; membranes; p-PROM; preterm delivery
Corresponding author: Prof. Tullio Ghi, MD, PhD, Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Viale A. Gramsci 14, 43126 Parma, Italy, Phone: +39 0521702434, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was approved by the local Ethics Committee (1007/2019).

References

1. Goldenberg, RL, Culhane, JF, Iams, JD, Romero, R. Epidemiology and causes of preterm birth. Lancet 2008;371:75–84. https://doi.org/10.1016/S0140-6736(08)60074-4.Suche in Google Scholar PubMed PubMed Central

2. Morris, JM, Roberts, CL, Bowen, JR, Patterson, JA, Bond, DM, Algert, CS, et al. Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial. Lancet 2016;387:444–52. https://doi.org/10.1016/S0140-6736(15)00724-2.Suche in Google Scholar PubMed

3. Thomson, AJ. Royal College of Obstetricians and Gynaecologists. Care of women presenting with suspected preterm prelabour rupture of membranes from 24(+0) Weeks of gestation: Green-top guideline No. 73. BJOG 2019;126:e152–66. https://doi.org/10.1111/1471-0528.15803 [Epub 2019 Jun 17]. PubMed PMID: 31207667.Suche in Google Scholar PubMed

4. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. Practice bulletin No. 172: premature rupture of membranes. Obstet Gynecol 2016;128:e165–77. https://doi.org/10.1097/AOG.0000000000001712. Review. PubMed PMID: 27661655.Suche in Google Scholar PubMed

5. Dagklis, T, Petousis, S, Margioula-Siarkou, C, Mavromatidis, G, Kalogiannidis, I, Prapas, N, et al. Parameters affecting latency period in PPROM cases: a 10-year experience of a single institution. J Matern Fetal Neonatal Med 2013;26:1455–8. https://doi.org/10.3109/14767058.2013.784257.Suche in Google Scholar PubMed

6. Frenette, P, Dodds, L, Armson, BA, Jangaard, K. Preterm prelabour rupture of membranes: effect of latency on neonatal and maternal outcomes. J Obstet Gynaecol Can 2013;35:710–7. https://doi.org/10.1016/S1701-2163(15)30861-6.Suche in Google Scholar PubMed

7. Drassinower, D, Friedman, AM, Običan, SG, Levin, H, Gyamfi-Bannerman, C. Prolonged latency of preterm premature rupture of membranes and risk of neonatal sepsis. Am J Obstet Gynecol 2016;214:743e1-6. https://doi.org/10.1016/j.ajog.2015.12.031.Suche in Google Scholar PubMed

8. Nayot, D, Penava, D, Da Silva, O, Richardson, BS, de Vrijer, B. Neonatal outcomes are associated with latency after preterm premature rupture of membranes. J Perinatol 2012;32:970–7. https://doi.org/10.1038/jp.2012.15.Suche in Google Scholar PubMed

9. Ramsey, PS, Lieman, JM, Brumfield, CG, Carlo, W. Chorioamnionitis increases neonatal morbidity in pregnancies complicated by preterm premature rupture of membranes. Am J Obstet Gynecol 2005;192:1162–6. https://doi.org/10.1016/j.ajog.2004.11.035.Suche in Google Scholar PubMed

10. Simhan, HN, Canavan, TP. Preterm premature rupture of membranes: diagnosis, evaluation and management strategies. BJOG 2005;112(Suppl 1):32–7. https://doi.org/10.1111/j.1471-0528.2005.00582.x.Suche in Google Scholar PubMed

11. Rouse, DJ, Hirtz, DG, Thom, E, Warner, MW, Spong, CY, Mercer, BM, et al. A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 2008;359:895–905. https://doi.org/10.1056/NEJMoa0801187.Suche in Google Scholar PubMed PubMed Central

12. Vidaeff, AC, Ramin, SM. Antenatal corticosteroids after preterm premature rupture of membranes. Clin Obstet Gynecol 2011;54:337–43. https://doi.org/10.1097/GRF.0b013e318217d85b.Suche in Google Scholar PubMed

13. Jobe, AH, Goldenberg, RL. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks. Am J Obstet Gynecol 2018;219:62–74. https://doi.org/10.1016/j.ajog.2018.04.007.Suche in Google Scholar PubMed

14. di Pasquo, E, Saccone, G, Angeli, L, Dall’Asta, A, Borghi, E, Fieni, S, et al. Determinants of neonatal hypoglycemia after antenatal administration of corticosteroids (ACS) for lung maturation: data from two referral centers and review of the literature. Early Hum Dev 2020;143:104984. https://doi.org/10.1016/j.earlhumdev.2020.104984.Suche in Google Scholar PubMed

15. Ville, Y, Rozenberg, P. Predictors of preterm birth. Best Pract Res Clin Obstet Gynaecol 2018;52:23–32. https://doi.org/10.1016/j.bpobgyn.2018.05.002.Suche in Google Scholar PubMed

16. Lee, SM, Park, KH, Jung, EY, Jang, JA, Yoo, HN. Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes. PLoS One. 2017; 12:e0174657. Published 2017 Mar 30. https://doi.org/10.1371/journal.pone.0174657.Suche in Google Scholar PubMed PubMed Central

17. Park, KH, Lee, SY, Kim, SN, Jeong, EH, Oh, KJ, Ryu, A. Prediction of imminent preterm delivery in women with preterm premature rupture of membranes. J Perinat Med. 2011;40:151‐7. Published 2011 Nov 16. https://doi.org/10.1515/JPM.2011.124.Suche in Google Scholar PubMed

18. Yagur, Y, Weitzner, O, Ravid, E, Biron-Shental, T. Can we predict preterm delivery in patients with premature rupture of membranes? Arch Gynecol Obstet 2019;300:615–21. https://doi.org/10.1007/s00404-019-05196-8.Suche in Google Scholar PubMed

19. Kayem, G, Batteux, F, Girard, N, Schmitz, T, Willaime, M, Maillard, F, et al. Predictive value of vaginal IL-6 and TNFα bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes. Eur J Obstet Gynecol Reprod Biol 2017;211:8–14. https://doi.org/10.1016/j.ejogrb.2017.01.013.Suche in Google Scholar PubMed

20. Trochez-Martinez, RD, Smith, P, Lamont, RF. Use of C-reactive protein as a predictor of chorioamnionitis in preterm prelabour rupture of membranes: a systematic review. BJOG 2007;114:796–801. https://doi.org/10.1111/j.1471-0528.2007.01385.x.Suche in Google Scholar PubMed

21. Mehra, S, Amon, E, Hopkins, S, Gavard, JA, Shyken, J. Transvaginal cervical length and amniotic fluid index: can it predict delivery latency following preterm premature rupture of membranes? Am J Obstet Gynecol 2015;212:400e1-9. https://doi.org/10.1016/j.ajog.2015.01.022.Suche in Google Scholar

22. Aviram, A, Quaglietta, P, Warshafsky, C, Zaltz, A, Weiner, E, Melamed, N The utility of ultrasound assessment in the management of preterm prelabor rupture of the membranes. Ultrasound Obstet Gynecol 2019. https://doi.org/10.1002/uog.20403 [Epub ahead of print, 2019 Jul 23].Suche in Google Scholar

23. Nune, V, Cross, J, Speich, JE, Morgan, DR, Strauss, JF3rd, Ramus, RM. Fetal membrane imaging and the prediction of preterm birth: a systematic review, current issues, and future directions. BMC Pregnancy Childbirth 2016;16:387. https://doi.org/10.1186/s12884-016-1176-5.Suche in Google Scholar

24. Frigo, P, Lang, C, Sator, M, Ulrich, R, Husslein, P. Membrane thickness and PROM--high-frequency ultrasound measurements. Prenat Diagn 1998;18:333–7. 9602478.10.1002/(SICI)1097-0223(199804)18:4<333::AID-PD264>3.0.CO;2-HSuche in Google Scholar

25. Severi, FM, Bocchi, C, Voltolini, C, Borges, LE, Florio, P, Petraglia, F. Thickness of fetal membranes: a possible ultrasound marker for preterm delivery. Ultrasound Obstet Gynecol 2008;32:205–9. https://doi.org/10.1002/uog.5406.Suche in Google Scholar

26. Dinglas, C, Chavez, M, Vintzileos, A. Resolution of intra-amniotic sludge after antibiotic administration in a patient with short cervix and recurrent mid-trimester loss. Am J Obstet Gynecol 2019;221:159. https://doi.org/10.1016/j.ajog.2019.01.003.Suche in Google Scholar

27. Salomon, LJ, Alfirevic, Z, Bilardo, CM, Chalouhi, GE, Ghi, T, Kogan, KO, et al. ISUOG practice guidelines: performance of first-trimester fetal ultrasound scan [published correction appears in Ultrasound Obstet Gynecol. 2013 Feb;41(2):240]. Ultrasound Obstet Gynecol 2013;41:102–13. https://doi.org/10.1002/uog.12342.Suche in Google Scholar

28. Lockwood, CJ, Wein, R, Chien, D, Ghidini, A, Alvarez, M, Berkowitz, RL. Fetal membrane rupture is associated with the presence of insulin-like growth factor-binding protein-1 in vaginal secretions. Am J Obstet Gynecol 1994;171:146–50. https://doi.org/10.1016/0002-9378(94)90461-8.Suche in Google Scholar

29. Higgins, RD, Saade, G, Polin, RA, Grobman, WA, Buhimschi, IA, Watterberg, K, et al. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: summary of a workshop. Obstet Gynecol 2016;127:426–36. https://doi.org/10.1097/AOG.0000000000001246.Suche in Google Scholar

30. Von Elm, E, Altman, DG, Egger, M, Pocock, SJ, Gotzsche, PC, Vandenbroucke, JP, for the STROBE Initiative. The strengthening the reporting of the observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007;370:1453–7. https://doi.org/10.1016/S0140-6736(07)61602-X.Suche in Google Scholar

31. Kumar, D, Moore, RM, Mercer, BM, Mansour, JM, Redline, RW, Moore, JJ. The physiology of fetal membrane weakening and rupture: insights gained from the determination of physical properties revisited. Placenta 2016;42:59–73. https://doi.org/10.1016/j.placenta.2016.03.015.Suche in Google Scholar

32. Hogge, WA, Hogge, JS, Boehm, CD, Sanders, RC. Increased echogenicity in the fetal abdomen: use of DNA analysis to establish a diagnosis of cystic fibrosis. J Ultrasound Med 1993;12:451–4. https://doi.org/10.7863/jum.1993.12.8.451.Suche in Google Scholar

33. Foster, MA, Nyberg, DA, Mahony, BS, Mack, LA, Marks, WM, Raabe, RD. Meconium peritonitis: prenatal sonographic findings and their clinical significance. Radiology 1987;165:661–5. https://doi.org/10.1148/radiology.165.3.3317498.Suche in Google Scholar

34. Buhimschi, CS, Buhimschi, IA, Norwitz, ER, Sfakianaki, AK, Hamar, B, Copel, JA, et al. Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios. Am J Obstet Gynecol 2005;193:762–70. https://doi.org/10.1016/j.ajog.2005.01.053.Suche in Google Scholar

35. Athayde, N, Edwin, SS, Romero, R, Gomez, R, Maymon, E, Pacora, P, et al. A role for matrix metalloproteinase-9 in spontaneous rupture of the fetal membranes. Am J Obstet Gynecol 1998;179:1248–53. https://doi.org/10.1016/s0002-9378(98)70141-3.Suche in Google Scholar

36. Maymon, E, Romero, R, Chaiworapongsa, T, Kim, JC, Berman, S, Gomez, R, et al. Value of amniotic fluid neutrophil collagenase concentrations in preterm premature rupture of membranes. Am J Obstet Gynecol 2001;185:1143–8. https://doi.org/10.1067/mob.2001.118166.Suche in Google Scholar

37. Shim, SS, Romero, R, Hong, JS, Park, CW, Jun, JK, Kim, BI, et al. Clinical significance of intra-amniotic inflammation in patients with preterm premature rupture of membranes. Am J Obstet Gynecol 2004;191:1339–45. https://doi.org/10.1016/j.ajog.2004.06.085.Suche in Google Scholar

38. Oh, KJ, Lee, JH, Romero, R, Park, HS, Joon-Seok, H, Yoon, BH. A new rapid bedside test to diagnose and monitor intra-amniotic inflammation in preterm PROM using transcervically collected fluid. Am J Obstet Gynecol 2020;223:423.e1–15. https://doi.org/10.1016/j.ajog.2020.02.037.Suche in Google Scholar

39. Ghidini, A, Salafia, CM, Minior, VK. Lack of relationship between histologic chorioamnionitis and duration of the latency period in preterm rupture of membranes. J Matern Fetal Med 1998;7:238–42. https://doi.org/10.1002/(SICI)1520-6661(199809/10)7:5<238::AID-MFM6>3.0.CO;2-5.10.1002/(SICI)1520-6661(199809/10)7:5<238::AID-MFM6>3.0.CO;2-5Suche in Google Scholar

40. Armstrong-Wells, J, Post, MD, Donnelly, M, Manco-Johnson, MJ, Fisher, BM, Winn, VD. Patterns of placental pathology in preterm premature rupture of membranes. J Dev Orig Health Dis 2013;4:249–55. https://doi.org/10.1017/S2040174413000056.Suche in Google Scholar
Received: 2020-05-23
Accepted: 2020-09-22
Published Online: 2020-10-22
Published in Print: 2021-03-26

© 2020 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. Clinical evaluation of labor: an evidence- and experience-based approach
  4. Original Articles – Obstetrics
  5. How fever is defined in COVID-19 publications: a disturbing lack of precision
  6. Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection
  7. Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden
  8. Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia – implications for clinical care
  9. Cytokine profiling: variation in immune modulation with preterm birth vs. uncomplicated term birth identifies pivotal signals in pathogenesis of preterm birth
  10. Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome
  11. A novel technique for prediction of preterm birth: fetal nasal flow Doppler
  12. Pregnant women’s knowledge and behaviour to prevent cytomegalovirus infection: an observational study
  13. Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks’ gestation
  14. First-trimester presentation of ultrasound findings in trisomy 13 and validation of multiparameter ultrasound-based risk calculation models to detect trisomy 13 in the late first trimester
  15. Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
  16. External validation of a prediction model on vaginal birth after caesarean in a The Netherlands: a prospective cohort study
  17. The influence of race on cervical length in pregnant women in Brazil
  18. Original Articles – Fetus
  19. A 24-segment fractional shortening of the fetal heart using FetalHQ
  20. Original Articles – Neonates
  21. Antenatal corticosteroids and short-term neonatal outcomes in term and near-term infants of diabetic mothers. Analysis of the Qatar PEARL-peristat registry
  22. Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants
  23. Quality improvement for reducing utilization drift in hypoxic-ischemic encephalopathy management
  24. Letter to the Editor
  25. Cross transmission of SARS-CoV-2 and obstetric ultrasound
  26. ‘Getting to zero’ cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic
https://doi.org/10.1515/jpm-2020-0223
Schlagwörter für diesen Artikel
latency; membranes; p-PROM; preterm delivery

Artikel in diesem Heft

  1. Frontmatter
  2. Review
  3. Clinical evaluation of labor: an evidence- and experience-based approach
  4. Original Articles – Obstetrics
  5. How fever is defined in COVID-19 publications: a disturbing lack of precision
  6. Initial review of pregnancy and neonatal outcomes of pregnant women with COVID-19 infection
  7. Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden
  8. Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia – implications for clinical care
  9. Cytokine profiling: variation in immune modulation with preterm birth vs. uncomplicated term birth identifies pivotal signals in pathogenesis of preterm birth
  10. Hyperechoic amniotic membranes in patients with preterm premature rupture of membranes (p-PROM) and pregnancy outcome
  11. A novel technique for prediction of preterm birth: fetal nasal flow Doppler
  12. Pregnant women’s knowledge and behaviour to prevent cytomegalovirus infection: an observational study
  13. Reference intervals and reliability of cavum septi pellucidi volume measurements by three-dimensional ultrasound between 19 and 24 weeks’ gestation
  14. First-trimester presentation of ultrasound findings in trisomy 13 and validation of multiparameter ultrasound-based risk calculation models to detect trisomy 13 in the late first trimester
  15. Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial
  16. External validation of a prediction model on vaginal birth after caesarean in a The Netherlands: a prospective cohort study
  17. The influence of race on cervical length in pregnant women in Brazil
  18. Original Articles – Fetus
  19. A 24-segment fractional shortening of the fetal heart using FetalHQ
  20. Original Articles – Neonates
  21. Antenatal corticosteroids and short-term neonatal outcomes in term and near-term infants of diabetic mothers. Analysis of the Qatar PEARL-peristat registry
  22. Acute respiratory effect of transpyloric feeding for respiratory exacerbation in preterm infants
  23. Quality improvement for reducing utilization drift in hypoxic-ischemic encephalopathy management
  24. Letter to the Editor
  25. Cross transmission of SARS-CoV-2 and obstetric ultrasound
  26. ‘Getting to zero’ cross transmission of SARS-CoV-2 in obstetric ultrasound during COVID-19 pandemic
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