Ultrasonographic Evaluation Of Cervical Length And Amniotic Fluid Index As Predictor Of Pregnancy Outcome In Cases Of Preterm Premature Rupture Of Membrane

Abstract

Background: In cases of preterm premature rupture of membrane (PPROM), the amniotic fluid index (AFI) and cervical length (CL) can be utilized to predict the outcome for the mother and the newborn, including delivery latency.

Aims and Objectives: The study's objectives were to measure the effectiveness of these parameters as predictors of pregnancy outcome in cases presenting with PPROM, investigate the AFI and CL as predictors of pregnancy outcome in cases presenting with PPROM, ascertain the AFI in cases presenting with PPROM, and ascertain CL ultrasonographically in cases presenting with PPROM. 

Materials and Methods: This observational study was carried out in the at Vinayaka missions Kirupananda variyar medical college, between February 2024 to July 2024. This study included 100 women who had a singleton pregnancy and a vertex presentation and who arrived at the hospital within 12 hours of a spontaneous rupture of the membrane (PPROM) during the 28–34+6 week gestation period. 

Results: At PPROM, the gestational period and delivery delay were inversely correlated (P<0.0001). Group 1's mean AFI was 5.15 cm, whereas Group 2's was 7.12 cm. There was a statistically significant difference between the two groups (P<0.0001). Our research thus demonstrates a favorable relationship between AFI and delivery latency. Group 1's mean transvaginal CL (TVCL) was 2.47 cm, whereas Group 2's TVCL was 2.99 cm. It was determined that there was a statistically significant difference in TVCL between the two groups (P=0.00005). Group 1 had a greater need for admission to the neonatal critical care unit than Group 2, and this difference was statistically significant (P=0.020).

Conclusion: According to our research, combining AFI and TVCL increases the positive predictive value for predicting delivery delay. Women with AFI ≤5 and TVCL ≤2.5 cm had an 85.6% chance of giving birth within 7 days following PPROM. Maternal morbidity (chorioamnionitis, abruption, and cord prolapse) and delivery latency were associated with longer CLs (TVCL >2.5 cm) and AFI >5.