Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes.
OBJECTIVE
To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM).


METHODS
A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher's exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test.


RESULTS
When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age.


CONCLUSIONS
The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.
Instituto de Medicina Integral Professor Fernando Figueira, Instituto de Medicina Integral Prof. Fernando Figueira, Fetal Medicine, Recife PE , Brazil, PhD in Maternal and Child Health - Sector Supervisor and Medical Residency Supervisor, Fetal Medicine/Instituto de Medicina Integral Prof. Fernando Figueira (Imip). Adjunct Professor, Maternal and Child Health Department/Universidade Federal de Pernambuco, Recife, PE, Brazil.
Alex Sandro Rolland
AS
Souza
Instituto Materno Infantil de Pernambuco, Imip, Recife PE , Brazil, MSc in Intensive Care - Nurse at the Imip, Recife, PE, Brazil.
Adriane Farias
AF
Patriota
Instituto Materno Infantil de Pernambuco, Imip, Obstetrics and Gynecology, Recife PE , Brazil, PhD in Obstetrics and Gynecology - Preceptor of Obstetrics and Gynecology at the Imip, Recife, PE, Brazil.
Gláucia Virgínia de Queiroz Lins
GV
Guerra
Instituto Materno Infantil de Pernambuco, Imip, Maternal and Child Health, Recife PE , Brazil, MSc in Maternal and Child Health - PhD Student in Maternal and Child Health at the Imip, Recife, PE, Brazil.
Brena Carvalho Pinto de
BC
Melo
D000293:Adolescent; D000328:Adult; D000653:Amniotic Fluid / Q000502:physiology*; D001034:Apgar Score; D001724:Birth Weight; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016104:Oligohydramnios / Q000503:physiopathology*; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult