The Impact of Amniotic Fluid Index (AFI) on Maternal and Perinatal Outcomes in Pregnant Women With Preterm Premature Rupture of Membranes
Condition: Premature Rupture of Membrane; Amniotic Fluid Leakage; Maternal Complication of Pregnancy; Fetal Complications
MeSH terms: Premature Birth; Fetal Membranes, Premature Rupture; Pregnancy Complications; Rupture
Study type: Observational

Summary: 
      Pregnant women who admitted with the complaint of amniotic fluid leakage between the
      gestational ages of 23+0 and 33+0 and who finally were diagnosed as PPROM were included in
      the study. Women with multiple gestations, cervical dilatation above 6 cm at the admission,
      hypertensive diseases, cervical cerclage, fetal anomalies, olgohydramnios, polihydramnios,
      and those who declined to involve in the study were excluded.

      In all included women were examined at the admission for amniotic fluid index via trans
      abdominal ultrasonography. AFI were measured by four quadrant technique, which is sum of the
      deepest vertical length of pocket of fluid in each quadrant without any umbilical cord. All
      included patients were assessed in two groups; women with AFI<5 and those with AFI≥5 cm.

      Included patients were followed in terms of maternal and fetal complications. Maternal
      complications were chorioamnionitis, placental abruption, placental retention, postpartum
      endometritis, postpartum hemorrhage; while fetal complications comprised necessity of
      admission to neonatal intensive care unit, neonatal sepsis, meconium aspiration syndrome,
      respiratory distress syndrome, intraventricular hemorrhage, umbilical cord pH below 7.10,
      APGAR score of 5th minute below 5. All complication rates were compared between the groups.
      In addition, the time period between the diagnosis of PPROM and the time of delivery was
      defined as latency period and were compared between the groups.
    

Detailed description: 
      Pregnant women who admitted with the complaint of amniotic fluid leakage between the
      gestational ages of 23+0 and 33+0 were examined for the inclusion criteria of the study.
      Among them, women with usual history of gross amniotic fluid leakage as well as classical
      speculum findings of ROM, such as pooling of amnitotic fluid within the posterior fornix or
      vaginal wall, were diagnosed as PPROM and included in the study without any further
      investigation. In case of the absence of these findings and suspected cases, PPROM was
      diagnosed via placental alpha-microglobulin-1 test from the vaginal fluid. Those with
      positive test results were included in the study. Women with multiple gestations, cervical
      dilatation above 6 cm at the admission, hypertensive diseases, cervical cerclage, fetal
      anomalies, olgohydramnios, polihydramnios, and those who declined to involve in the study
      were excluded.

      In all included women were examined at the admission for amniotic fluid index via trans
      abdominal ultrasonography. AFI were measured by four quadrant technique, which is sum of the
      deepest vertical length of pocket of fluid in each quadrant without any umbilical cord. All
      included patients were assessed in two groups; women with AFI<5 and those with AFI≥5 cm.

      Included patients were followed in terms of maternal and fetal complications. Maternal
      complications were chorioamnionitis, placental abruption, placental retention, postpartum
      endometritis, postpartum hemorrhage; while fetal complications comprised necessity of
      admission to neonatal intensive care unit, neonatal sepsis, meconium aspiration syndrome,
      respiratory distress syndrome, intraventricular hemorrhage, umbilical cord pH below 7.10,
      APGAR score of 5th minute below 5. All complication rates were compared between the groups.
      In addition, the time period between the diagnosis of PPROM and the time of delivery was
      defined as latency period and were compared between the groups.
    

Intervention name(s): AFI via transabdominal ultrasonography
Intervention type(s): Other
Intervention description(s): AFI via transabdominal ultrasonography was performed at the time of diagnosis.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Pregnant women who were diagnosed as PPROM between 23+0 and 33+0 gestational ages.