Trans-Vaginal Cervical Length and Amniotic Fluid Index in Prediction of Delivery Latency Following Preterm Pre-Labor Rupture of Membranes

Abstract

Abstract Background After premature pre-labor rupture of membranes (PPROM), it is challenging to forecast with precision the time to delivery (latency). Predicting delivery delay may be useful in determining when to recommend hospitalization, close observation, prenatal steroid use, and magnesium sulfate for neuroprotection. In women who report with preterm pre-labor rupture of membranes (PPROM), our goal is to ascertain if transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict delivery latency. Methods 70 pregnant women presented with PPROM between the gestational age of 28 weeks and 36 weeks +6 days were enrolled. Transvaginal ultrasound measurement of cervical length and amniotic fluid index was performed within 24 hours of admission, to assess number of women reached latency period of 7 days or more and assess other maternal and fetal parameters as number of women reached 36 +6 weeks, mode of delivery, development of chorioamnionitis, gestational age at PPROM and delivery, birthweight at delivery, presence of neonatal sepsis, Apgar score at 1 and 5 minutes and need for NICU admission and indication. Results The best sensitivity of TVCL in prediction of delivery latency was 100 % at TVCL>3 cm in women with AFI >5 cm. On the other hand, the best specificity was 80.5% at TVCL>3 cm in women with AFI ≤5 cm. Conclusion When a woman presents with preterm pre-labor rupture of the membranes, it is recommended to employ either transvaginal cervical length, amniotic fluid index, or both to forecast delivery delay.