Predictors of Caesarean Delivery in Preterm Premature Rupture of Membranes

Samantha Mc Kenzie Stancu; Liran Kobi Ash; Cynthia Smeding; Maisa Abdullah Alwan

doi:10.3889/oamjms.2019.250

Authors

Samantha Mc Kenzie Stancu Homerton University Hospital, NHS Foundation Trust, London, United Kingdom
Liran Kobi Ash Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
Cynthia Smeding Medical University of Warsaw, Warsaw, Poland
Maisa Abdullah Alwan Medical University of Warsaw, Warsaw, Poland

DOI:

https://doi.org/10.3889/oamjms.2019.250

Keywords:

preterm premature rupture of membranes;, caesarean delivery;, predictors;, outcomes

Abstract

BACKGROUND: Preterm premature rupture of membranes (P-PROM) exerts a tremendous influence on pregnancy prognosis. Additionally, it is a major public health concern, as the cause of up to 40% of all preterm births.

AIM: The objective of this study was to identify predictors of Caesarean Delivery in singleton pregnancies complicated by P-PROM.

MATERIALS AND METHODS: This is a retrospective observational study of all consecutive singleton P-PROM deliveries (24-37 weeks) over an 18 months at a tertiary referral centre. Pertinent data was collected comprising demographics, obstetric history, pregnancy-associated pathology and delivery from electronic patient records. Univariate statistical analysis comprised Odds Ratio, 95% Confidence interval and Chi-square test with subsequent p-value with statistical significance set at p < 0.05.

RESULTS: A total of 240 women delivered singletons following P-PROM over an 18-month period. Maternal age ranged between 12-41 years with an average age of 28 Â± 6.27 years. Vaginal delivery (VD) was the predominant mode of delivery, accounting for 52.9% (n = 127) of deliveries. The following parameters were identified as predictors of Caesarean Section (CS) in P-PROM: vaginal infection (p = 0.04), previous CS (p < 0.0001), primiparity (p = 0.004), gravidity > 5 (p = 0.009), university education (p = 0.0006) and prenatal care (p < 0.0001).

CONCLUSION: The advantage of CS over vaginal delivery is expedited delivery of the distressed fetus, while that of vaginal delivery entails avoiding postoperative morbidity. However, large multicentric randomised-controlled studies are needed to elucidate this dilemma definitively.

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