Downloads: 1 | Views: 72 | Weekly Hits: ⮙1 | Monthly Hits: ⮙1

Analysis Study Research Paper | Gynaecology | India | Volume 13 Issue 1, January 2024 | Rating: 5.2 / 10

Relationship of Amniotic Fluid Index and Cervical Length with Delivery Latency in Patients with Preterm Premature Rupture of Membranes (PPROM): A Hospital Based Study

Dr. Mustafeez ur Rehman | Dr. Abjeet Kour ^[3] | Dr. Asif Iqbal | Dr. Showkat Ahmad Dar | Dr. Insha Fayaz

Abstract: Objective: We sought to find the relationship of Amniotic fluid index (AFI) and cervical length with delivery latency among patients with preterm premature rupture of membranes (PPROM) and to determine overall pregnancy outcome in pregnancies complicated with PPROM. Study Design: This study was a prospective observational study conducted in Lalla Ded hospital Srinagar, in women with PPROM who consented to undergo Sonographic measurement after admission. Total of 312 patients were studied. All women with PPROM were hospitalized and diagnosis of PPROM was established on the basis of a history suggesting amniotic fluid leakage and sterile speculum examination demonstrating either amniotic fluid passing through the cervix or fluid accumulation in the posterior vaginal fornix and were managed according to the hospital protocol. Maternal outcomes were recorded in terms of latency period, chorioamnionitis, and abruption and neonatal outcomes were recorded in terms of birth weight, first minute APGAR score. Further follow up was done till the patient was discharged from the hospital for late maternal and neonatal complications. Latency was stratified into two groups: A) <7 days, and 2) ?7 days, Period Of gestation was stratified into two groups. B) 28-33weeks, and 2) 34-36weeks. C) Amniotic fluid index was stratified into two groups 1) AFI <5cms and 2) AFI ? 5cms. Results: Out of 312 patients 169 patients had latency period of less than 7 days and 143 patients had latency period of more or equal to 7 days. Most of patients with AFI <5 and/or CL <2 delivered within 7 days and most of patients with AFI ?5 and/or CL ?2 were having delivery latency ?7 days. So delivery latency was directly related to amount of AFI and cervical length. Most of patients with POG <34 weeks delivered with delivery latency ?7 days and most of patients with POG ?34 weeks delivered with delivery latency <7 days .Amongst the babies who developed complications most of them babies were extreme preterm. The complications seen in preterm infants in our setting were Respiratory distress syndrome, hypothermia, hypoglycaemia, intra cranial haemorrhage, Apnoea of prematurity, Necrotizing enterocolitis, sepsis and death. The survival and salvageability of these preterm babies were dependent on their gestational age, birth weight and Apgar score. Babies with late preterm gestation were having good birth weight and good Apgar score were found less prone to these complications and vice versa. Conclusion: A shorter TVCL (Transvaginal cervical length) and lesser AFI independently predict delivery within 7 days in women presenting with PPROM. The combination of an AFI ?5 cm and TVCL ?2 cm greatly improved the potential to remain undelivered after 7 days and vice versa. These findings may be helpful for counselling and optimizing maternal and neonatal care in women with PPROM. Latency is inversely proportional to period of gestation which means lesser the period of gestation more will be the latency period. Since the latency cannot be absolutely predicted in advance in pre-term pre-mature rupture of membranes, women with shorter cervix and lesser amniotic fluid index needs to be hospitalized and managed aggressively and should be monitored vigorously for further complications. The women with longer cervix and higher amniotic fluid may require a longer duration of antibiotic coverage since the latency period is more.

Keywords: amniotic fluid index, cervical length, labour latency, preterm birth, preterm premature rupture of membranes, transvaginal cervical length

Edition: Volume 13 Issue 1, January 2024,

Pages: 569 - 575