Amniotic fluid volume and maternal outcomes in women with preterm premature rupture of membranes

• Published in: Revista Brasileira de ginecologia e obstetrícia Vol. 36; no. 4; pp. 146 - 151
• Main Authors: Patriota, Adriane Farias, Guerra, Gláucia Virgínia de Queiroz Lins, de Melo, Brena Carvalho Pinto, Santos, Alessandra Coelho, Torres Júnior, Alberto Callou, Souza, Alex Sandro Rolland
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 01.04.2014
• Subjects: Amniotic Fluid; Cohort Studies; Female; Fetal Membranes, Premature Rupture - physiopathology; Humans; Pregnancy; Pregnancy Outcome; Retrospective Studies
• ISSN: 1806-9339
• DOI: 10.1590/S0100-720320140050.0003

To describe the potential influence of amniotic fluid on the maternal outcome of preterm premature rupture of membranes (PROM). An observational, retrospective cohort study was conducted between December 2012 and January 2008 on 86 pregnant women with preterm PROM and a gestational age (GA) of 24 to 35 weeks. The amniotic fluid index (AFI) was used to measure aminiotic fluid volume. Pregnant women were compared at two cut-off points: those with AFI <5.0 and ≥5.0 cm and AFI <3.0 and ≥3.0 cm. We excluded women with hypertensive disorders, diabetes mellitus, fetal malformations and a diagnosis of infections at admission. For statistical analysis, we used the χ2 test or Fisher's exact test, when appropriate, and simple linear regression analysis, with the level of significance set at 5%. We calculated the Risk Ratio (RR) and its 95% confidence interval (95%CI). When maternal outcomes were assessed by comparing ILA ≥5.0 versus <5.0 cm, no significant differences were detected. However, when considering ILA <3.0 and ≥3.0 cm, there was an increased risk of chorioamnionitis (36.7 versus10.7%, RR: 3.4, 95%CI 1.4 -8.3, p=0.004), with no significant differences for the other variables. There was also a statistically significant positive correlation between AFI and gestational age at delivery (R2=0.78, p<0.0001). AFI <3.0 cm causes a three-fold increase in the risk for chorioamnionitis; also, the higher the ILA, the higher the gestational age at delivery.