WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Lama Zaoda, Basel Mohamed and Thawra Naissa

ABSTRACT

Background: Preterm premature rupture of membranes (PPROM) is a complication responsible for a third of preterm births. The prediction of time of labor complicated with PPROM is crucial for reducing maternal and neonatal complication. Objective: This study set out to determine whether transvaginal cervical length (TVCL), amniotic fluid index (AFI), or a combination of both can predict the time of labor within 7 days in women presenting with preterm premature rupture of membranes (PPROM). Methods: This was a prospective observational study carried out at Tishreen University Hospital in Lattakia-Syria during the period between (2022-2023).The study included 90 pregnant women with PPROM between 24–34 weeks. Cervical length and amniotic fluid index were measured in all women, with our primary outcome time of labor within 7 days of TVCL. Results: The study showed that the validity of CL alone in predicting labor when the cutoff value = 2 cm, the sensitivity = 54.76%, specificity =64.58%, positive predictive value (PPV) = 57.5%, negative predictive value (NPV) = 62%, and accuracy = 60%. The validity of AFI alone when the cutoff value = 5 cm, the sensitivity = 71.42%, specificity = 54.16%, PPV = 57.60%, NPV = 68.42%, and accuracy =62.22%. With a combination of CL and AFI in predicting time of labor after PPROM, the following results were found: sensitivity = 52.38%, specificity = 89.58%, PPV = 81.48%, NPV = 68.25%, and accuracy = 72.22%. Conclusion: The combination of the amniotic fluid index and the length of the cervix led to an increase in the specificity and positive predictive value in the prediction of time of labor. The study showed that women who have (AFI < 5cm, CL < 2cm) after preterm premature rupture of the membranes had an 81.48% risk of onset of labor within 7 days.

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