OBJECTIVES: The objective of this study was to determine the most accurate method to use for the diagnosis of membrane rupture as well as to compare the sensitivity, specificity, positive and negative predictive values of such different methods.

METHODOLOGY: This prospective, non-randomized, descriptive study included 100 subjects, 50 each for the control group or women with intact membranes documented by history and physical examination, and gold standard group or women with ruptured membranes documented by history and pooling of amniotic fluid on speculum examination. Endocervical samples for control group (no pooling) and vaginal/posterior fornix samples for gold standard group (with pooling of fluid) were obtained from each patient used to test for determination using Actim^TM PROM test kit, ferning test, and pH testing using litmus paper.

RESULT: Ferning's test, Litmus paper test and Actim^TM PROM test have sensitivity of 30%, 44% and 74%, respectively specificity of 100%, 96%, 96% and respectively; PPV of 100%, 91.7% and 94.9% respectively; and NPV of 58.8%, 63.2% and 78.7% respectively. Actim PROM test kit was noted to be superior in terms of accuracy, followed by Litmus paper test, and lastly, by Ferning test as shown by the Receiver Operating Characteristic curve.

CONCLUSIONS: Actim^TM PROM test was noted to have the highest accuracy, as evidenced by the result of ROC curve, with the highest probability of testing positive in patients with true rupture of membranes, and with the highest Kappa statistic value or lowest probability of having interobserver variability.

Human ; Female ; Adult ; Fetal Membranes, Premature Rupture-diagnosis ; Preterm Premature Rupture of the Membranes

Premature prelabor rupture of membranes (PPROM) is defined as rupture of membranes before 37 completed weeks. The diagnosis of rupture of membranes can be made by using sterile speculum examination. Amniotic fluid is seen pooling in the posterior fornix or clear fluid is passing from the cervical canal. Presented is a case of PPROM which was managed with transabdominal amniotransfusion. The effects of amnioinfusion on pregnancy outcome in preterm premature rupture of membranes (PPROM) are unclear. Postulated benefits include prolongation of the latency period and prevention of pulmonary hypoplasia and infection. Transabdominal amnioinfusion is a promising procedure. It can be a very useful procedure in special cases, such as, preterm prelabor rupture of membrane to improve neonatal survival and outcome.

Human ; Female ; Adult ; Pregnancy ; Preterm Premature Rupture Of The Membranes ; Pregnancy Outcome ; Amniotic Fluid ; Fetal Membranes, Premature Rupture ; Delivery, Obstetric ; Vagina

OBJECTIVETo analyze the relationship between periodontal condition and premature rupture of membrane (PROM) in order to provide basis to keep pregnant women from oral diseases.

METHODS18 cases of preterm pregnant women with PROM (Group PPROM) and 20 cases of full-term pregnant women with PROM (Group PROM) were selected as the study group, and 28 cases of full-term normal pregnant women were selected as the control group. Everyone's plaque index (PLI), probing depth (PD) and sulcular bleeding index (SBI) were checked and recorded. Meanwhile, immunohistochemical method was used to detect the distribution and expression of matrix metalloproteinase-9 (MMP-9) in fetal membrane of cervix. The relationship between the expression of MMP-9 and PROM was analyzed.

RESULTSThe expression of MMP-9 in the pregnant women with PROM (Group PPROM and Group PROM) was higher than that in the control group. There was no relationship between the expression of MMP-9 in chorion and PD (r = 0.053, P = 0.075). The expression of MMP-9 in chorion had direct correlation with SBI (r = 0.433, P < 0.05) and PLI (r = 0.310, P < 0.05). The expression of MMP-9 in amniotic membrane hadn't dependence with PD (r = 0.077, P = 0.597), while had direct correlation with SBI (r = 0.430, P < 0.05) and PLI (r = 0.324, P < 0.05).

CONCLUSIONMMP-9 was involved in the pathological process of PROM and periodontal inflammation.

Female ; Fetal Membranes, Premature Rupture ; Humans ; Inflammation ; Matrix Metalloproteinase 9 ; Pregnancy

OBJECTIVES: To study the association of the anti-oxidative damage factors nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NAD(P)H:quinone oxidoreductase-1 (NQO1) with preterm premature rupture of membranes (PPROM). METHODS: A prospective study was conducted. The neonates who were hospitalized in Yanbian Hospital from 2019 to 2020 were enrolled as subjects, among whom there were 30 infants with PPROM, 32 infants with term premature rupture of membranes (TPROM), and 35 full-term infants without premature rupture of membranes (PROM). Hematoxylin and eosin staining was used to observe the inflammatory changes of placental tissue. Immunohistochemical staining was used to measure the expression of Nrf2, HO-1, and NQO1 in placental tissue. Western blot was used to measure the protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue. RESULTS: Compared with the PPROM group, the TPROM group and the non-PROM full-term group had significantly higher positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue (P<0.05). There were no significant differences in the positive expression rates and relative protein expression levels of Nrf2, HO-1, and NQO1 in placental tissue between the TPROM and non-PROM full-term groups (P>0.05). CONCLUSIONS The low expression levels of Nrf2, HO-1, and NQO1 in placental tissue may be associated with PPROM, suggesting that anti-oxidative damage is one of the directions to prevent PPROM.
Female ; Fetal Membranes, Premature Rupture ; Humans ; Infant, Newborn ; Infant, Premature ; Oxidative Stress ; Placenta/metabolism* ; Pregnancy ; Prospective Studies

To study the characteristics of heart rate rhythm in pregnant women at different trimester of pregnancy, and to explore the relationship between the basic rhythm of heart rate and pregnancy complications. Thirteen pregnant women who were diagnosed with normal early pregnancy in the Reproductive Center of the Second Affiliated Hospital of Soochow University from June 2018 to December 2019 were prospectively selected. Personal files were created and the heart rate data of pregnancy women was collected 24 hours a day by wearable devices until delivery. Prenatal examination and pregnancy outcomes were surveyed at follow-up. The cosine analysis method and the designed statistical module were used to analyze the long-term rhythm of pregnant women's heart rate. The heart rate of pregnant women showed a significant rhythm at different gestational weeks. Compared with the gestational week of 12, the midline-estimating statistic of rhythm(MESOR) increased significantly at the gestational week of 28 and 32 (t=-2.751,P=0.013;t=-2.314,P=0.032).The phase of rhythm shifted from 14∶00 pm in the first trimester of pregnancy (12 weeks) to 16∶00 pm in the second trimester (24 weeks) (t=2.613,P=0.018) and returned to 14∶00 pm at the third trimester (32 weeks) (t=-2.176,P=0.046). Season had no significant effect on the changes of MESOR, amplitude and phase of maternal heart rate in the first trimester (t=-0.356,P=0.729;t=-0.777,P=0.464;t=-0.434,P=0.673), while season had no significant effect on the changes of MESOR, amplitude and phase in the third trimester (t=-0.663,P=0.532;t=-0.209,P=0.841;t=0.625,P=0.592). The heart rate of one pregnant woman with natural delivery had rhythm disorder from the start of labor to delivery. The heart rate of one pregnant woman with premature rupture of membranes showed rhythm disorder before and after the rupture of membranes, and smaller amplitude. Rhythm disturbance may play a suggestive role in preterm delivery and labor initiation. In conclusion, pregnancy may cause changes in the internal heart rate rhythm. Maternal internal rhythm disturbance may occur when delivery or premature rupture of membranes occurs. The heart rate rhythm of pregnant women may be related to some common complications of pregnancy such as premature rupture of membranes.
Infant, Newborn ; Pregnancy ; Female ; Humans ; Fetal Membranes, Premature Rupture ; Pregnancy Outcome ; Pregnancy Complications ; Pregnancy Trimester, Third ; Premature Birth ; Periodicity

To study the characteristics of heart rate rhythm in pregnant women at different trimester of pregnancy, and to explore the relationship between the basic rhythm of heart rate and pregnancy complications. Thirteen pregnant women who were diagnosed with normal early pregnancy in the Reproductive Center of the Second Affiliated Hospital of Soochow University from June 2018 to December 2019 were prospectively selected. Personal files were created and the heart rate data of pregnancy women was collected 24 hours a day by wearable devices until delivery. Prenatal examination and pregnancy outcomes were surveyed at follow-up. The cosine analysis method and the designed statistical module were used to analyze the long-term rhythm of pregnant women's heart rate. The heart rate of pregnant women showed a significant rhythm at different gestational weeks. Compared with the gestational week of 12, the midline-estimating statistic of rhythm(MESOR) increased significantly at the gestational week of 28 and 32 (t=-2.751,P=0.013;t=-2.314,P=0.032).The phase of rhythm shifted from 14∶00 pm in the first trimester of pregnancy (12 weeks) to 16∶00 pm in the second trimester (24 weeks) (t=2.613,P=0.018) and returned to 14∶00 pm at the third trimester (32 weeks) (t=-2.176,P=0.046). Season had no significant effect on the changes of MESOR, amplitude and phase of maternal heart rate in the first trimester (t=-0.356,P=0.729;t=-0.777,P=0.464;t=-0.434,P=0.673), while season had no significant effect on the changes of MESOR, amplitude and phase in the third trimester (t=-0.663,P=0.532;t=-0.209,P=0.841;t=0.625,P=0.592). The heart rate of one pregnant woman with natural delivery had rhythm disorder from the start of labor to delivery. The heart rate of one pregnant woman with premature rupture of membranes showed rhythm disorder before and after the rupture of membranes, and smaller amplitude. Rhythm disturbance may play a suggestive role in preterm delivery and labor initiation. In conclusion, pregnancy may cause changes in the internal heart rate rhythm. Maternal internal rhythm disturbance may occur when delivery or premature rupture of membranes occurs. The heart rate rhythm of pregnant women may be related to some common complications of pregnancy such as premature rupture of membranes.
Infant, Newborn ; Pregnancy ; Female ; Humans ; Fetal Membranes, Premature Rupture ; Pregnancy Outcome ; Pregnancy Complications ; Pregnancy Trimester, Third ; Premature Birth ; Periodicity

OBJECTIVEThis study investigated the life style and health status of preterm and term infants' mothers in order to explore the risk factors for preterm delivery.

METHODSA total of 600 matched cases, including 120 pairs of preterm infants and their mothers and 180 pairs of term infants and their mothers were recruited. All of the mothers participated in a questionnaire survey on life style and health status during or before pregnancy. General data of the infants were also collected. Logistics regression analysis was used for evaluating the risk factors for preterm delivery.

RESULTSThe height, body weights and body mass index before pregnancy in preterm infants' mothers were significantly lower than those in term infants' mothers (p<0.05). The birth height and weights and Apgar scores in preterm infants were significantly lower than those in term infants (p<0.05). The whole nutritional Knowledge-Attitude-Practice (KAP) scores in preterm infants' mothers were significantly lower than those in term infants' mothers (P<0.05). Multiple factor regression analysis showed that recurrent abortions before gestation (OR=2.332, P<0.05) and premature rupture of membrane before delivery (OR=7.979, P<0.01) were risk factors for preterm delivery, while maternal nutritional KAP scores (OR=0.949, P<0.01) and body weights before pregnancy (OR=0.954, P<0.05) were protective factors.

CONCLUSIONSThe women with low body weight, low nutritional KAP scores or recurrent abortions history before pregnancy or presenting premature rupture of membrane before delivery are at high risk for preterm delivery.

Case-Control Studies ; Female ; Fetal Membranes, Premature Rupture ; etiology ; Health Knowledge, Attitudes, Practice ; Health Status ; Humans ; Infant, Newborn ; Infant, Premature ; Life Style ; Logistic Models ; Pregnancy ; Premature Birth ; etiology

OBJECTIVE: To study the clinical features of very preterm infants with prelabor rupture of membranes (PROM) and predictive factors for early-onset sepsis (EOS) and death. METHODS: A retrospective analysis was performed for the clinical data of the very preterm infants with PROM (with a gestational age of < 32 weeks) who were admitted to the neonatal intensive care unit from January 2018 to May 2020. According to the time from membrane rupture to delivery, the infants were divided into four groups: < 18 hours ( RESULTS: There was no significant difference in the incidence rates of major neonatal complications and mortality rate among the very preterm infants with different times of PROM ( CONCLUSIONS Prolonged PROM does not increase the incidence of neonatal complications and mortality in very preterm infants. Adverse outcomes of very preterm infants with PROM are mainly associated with lower birth weights, lung immaturity, and systemic infection.
Female ; Fetal Membranes, Premature Rupture ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; Infant, Very Low Birth Weight ; Pregnancy ; Retrospective Studies

To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with that of c-reactive protein (CRP) for detecting chorioamnionitis (CAM) in serum of women with premature rupture of membranes (PROM), 55 pregnant women with PROM, including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term (TPROM) were studied. Maternal serum were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA) for sICAM. CAM was histologically confirmed after delivery. The results revealed that (1) maternal serum levels of sICAM-1 and CRP were significantly higher in women with PROM than those without it; (2) maternal serum levels of sICAM-1 and CRP were significantly higher in women with CAM than those without it; (3) serum levels of sICAM-1 in PPROM women were similar to those in TPROM women, whereas serum levels of CRP in PPROM women were significantly higher than those in TPROM women; (4) the sensitivity, specificity, positive predictive value, negative predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1 (cutoff 104.7 ng/ml) and CRP (cutoff 1.03 mg/dl) for diagnosing CAM were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) among the mild histological CAM group, severe histological CAM group and clinical CAM group, the difference in maternal serum levels of sICAM-1 were significantly (P<0.001), with the order of concentration from high level to low level corresponding to the severity of CAM. It is concluded that maternal serum level of ICAM-1 is superior to that of CRP as biomarker for diagnosing intraamniotic infection in pregnant women with PROM.
Biological Markers/blood ; Chorioamnionitis/*blood ; Chorioamnionitis/diagnosis ; Chorioamnionitis/etiology ; Fetal Membranes, Premature Rupture/*blood ; Intercellular Adhesion Molecule-1/*blood

OBJECTIVE: To investigate pregnancy complications and related determinants, and provide scientific evidence for maternal health care. METHODS: A total of 13669 pregnant women who planned to deliver in the hospital were randomly identified and surveyed by questionnaire. Chi-square test and logistic regression models were used to screen the influencing factors for pregnancy complications. RESULTS: The incidence of pregnancy complication was 13.94%. The following diseases had higher incidence than others: anemia (2.95%), premature rupture of membranes (2.51%), diabetes (1.92%), severe preeclampsia (1.43%), mild preeclampsia (1.27%), and hypertensive disorder complicating pregnancy (1.27%). Data from logistic regression models showed that pregnancy complications were related to maternal age, education level, number of caesarean sections, ways to terminate pregnancy, gestation weeks and number of fetuses. CONCLUSION The rate of pregnant complication is high, which should be treated in time to ensure the safety of pregnant women.
Anemia ; Cesarean Section ; Diabetes, Gestational ; Female ; Fetal Membranes, Premature Rupture ; Gestational Age ; Humans ; Pre-Eclampsia ; Pregnancy ; Pregnancy Complications ; epidemiology