Expectant management of preterm prelabour rupture of membranes--the significance of oligohydramnios at presentation.
In a retrospective study, the relationship between oligohydramnios (largest amniotic fluid pocket less than 2 x 2 cm) at the time of presentation and the outcome of expectant management of patients with preterm (< 35 weeks) prelabour rupture of membranes (PROM) was examined in 62 patients admitted with a confirmed diagnosis and in the absence of complications or established labour. There were no differences in the maternal age, incidence of multiparity, or additional complications between patients without (Group 1, n = 24) and with (Group 2, n = 38) oligohydramnios. However in Group 2, 44.7% of the patients developed PROM before 28 weeks and 63.2% were delivered within 48 h of assessment, in contrast to 20.8% (P < 0.05) and 12.5% (P < 0.001), respectively, in Group 1. Group 2 patients had a higher incidence of histological chorioamnionitis (55.3% vs. 29.3%, P < 0.05) and funisitis (44.7% vs. 16.7%, P < 0.02), an earlier mean gestation at delivery (29.1 +/- 2.8 weeks vs. 31.5 +/- 2.0 weeks, P < 0.001) and lower birth weight (1373 +/- 467 g vs. 1856 +/- 496 g, P < 0.001). Our results indicate that oligohydramnios at presentation of preterm PROM is an unfavourable prognostic sign in the expectant management of these pregnancies.
Perinatal Unit, Women's College Hospital, Toronto, Ontario, Canada.
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Lao
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Cheung
D000293:Adolescent; D000328:Adult; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications / Q000628:therapy*; D006801:Humans; D016104:Oligohydramnios / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies