AMNIOTIC-FLUID VOLUME AS A RISK FACTOR IN PRETERM PREMATURE RUPTURE OF THE MEMBRANES

  • 1 January 1985
    • journal article
    • research article
    • Vol. 65  (4) , 456-459
Abstract
During a prospective study evaluating the expectant management of preterm (26-34 wk) premature rupture of membranes (PROM), maternal and neonatal outcome of 17 patients with a marked reduction in amniotic fluid volume were compared with 22 subjects having identifiable pockets of amniotic fluid after membrane rupture. The results demonstrated no significant differences in maternal age, gravidity, cervical dilatation, incidence of labor on admission, use of tocolytics, steroid usage, interval from membrane rupture to delivery, or cesarean section rate. The gestational age at which PROM occurred (31.4 .+-. 1.9 vs. 29.8 .+-. 2.2 wk) was significantly (P < 0.05) more advanced in the adequate fluid patients when compared with the reduced fluid group. Clinical amnionitis was a far more common occurrence in the reduced fluid patients when compared with the adequate fluid group (47 vs. 14%, respectively, P < 0.05) as was postpartum endometritis (59 vs. 18%, P < 0.05). The incidence of overt neonatal sepsis was similar between the adequate fluid (14%) and reduced fluid (18%) patients. These results suggest that when a marked reduction in amniotic fluid after PROM is identified, patients are at a 3-times greater risk for antepartum amnionitis and postpartum endometritis.