Monitoring of the Inflammatory Response of Patients With Premature Rupture of Membranes With Bedside Tests
Condition: Premature Rupture of Fetal Membranes
MeSH terms: Premature Birth; Fetal Membranes, Premature Rupture; Rupture
Study type: Observational

Summary: 
      Prematurity represents 8% of birth and it is one of the leading causes of infant
      complications. The preterm premature rupture of membranes (PPROM) represents one-third of
      preterm birth and the rupture of membranes increase the risk of fetal exposition to infection
      which could lead to neurological sequels. Classic management of women with PPROM before 32SA
      is based on the extension of the pregnancy with the risk of adding complications like a
      secondary infection. Moreover, different studies have shown that fetal infection could be one
      of the most important risk factor for subsequent neurological complications. However, it is
      difficult to know if it is better to extend the pregnancy to gain in maturity or to arrest
      the pregnancy to avoid the risk of intrauterine infection. The research objective is to
      suggest a new strategy to manage women with PPROM. With this new strategy, the investigators
      seek to extend pregnancy as much as possible but the investigators would like to give birth
      before the intrauterine infection. The investigators suggest detecting protein associate with
      neurological complications of preterm child in the amniotic liquid found in the vagina of the
      mother. A positive test will lead to the delivery of the newborn before its infection. The
      hypothesis is that it is possible to study changes in the inflammatory status of patients who
      presented an PPROM from repeated detection of interleukins in vaginal secretions.
    

Detailed description: 
      Preterm premature rupture of the membranes (PPROM) represents one-third of preterm births and
      is the leading cause of perinatal mortality and morbidity. During the latency period, several
      events such as the ascent of pathogenic microorganisms from the lower genital area could
      create complications which may culminate in cerebral palsy. Avoiding intrauterine infection
      appears as one of the most important objective in the PPROM management. Most authors propose
      the conservative management of women with PPROM, associating antibiotic therapy to
      corticosteroid administration in patients with PPROM before 30 to 32 weeks. The main benefit
      of conservative management is prolonging pregnancy, but the benefit must be balanced with the
      risks of fetal complications. In an effort to diminish the risks of infection linked to a
      longer latency period, several authors have proposed intentional delivery after PPROM.

      The primary objective is the comparison between the results of IMMUNOCHROMATOGRAPHY tests
      done at the bedside of the patient and the ELISA tests performed in the laboratory.

      The secondary outcome is the description of the inflammatory status following a rupture of
      membranes at term and during labor.

      Vaginal secretions samplings are perform after premature rupture of membranes and during
      labor. The bedside test is performing immediately after sampling and the rest of the sampling
      is frozen. ELISA assays will be performed on these samples.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        women hospitalized for premature rupture of membranes at the CHUS
      
Biospecimen description: 
      vaginal secretions
    
Keywords: bedside test; interleukins; inflammation; vaginal secretions