Zhou Shuwei, Mei Lingwei, Zhou Wei, Yang Yajun, Zhang Xiaoyan, Mu Xiaoling, Quan Quan, Wang Lan
Department of Obstetrics, Chongqing Health Center for Women and Children, Chongqing, China.
Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Med (Lausanne). 2022 Mar 4;9:839240. doi: 10.3389/fmed.2022.839240. eCollection 2022.
There is a lack of literature on short latency period (SLP) in twin pregnancies with preterm premature rupture of membranes (PPROM). Thus, the aim of this study was to identify the clinical factors and perinatal outcomes associated with SLP in twin pregnancies with PPROM and to establish a predictive model to identify SLP.
Twin pregnancies with PPROM between 24 0/7 and 33 6/7 weeks were included and a retrospective analysis was performed. Patients were divided into two groups based on the latency period after PPROM: Group 1 ≤24 h (defined as SLP) and Group 2 >24 h (defined as long latency period, LLP), the clinical factors and perinatal outcomes were compared between the two groups. Binary logistic regression and receiver operating characteristic curve analyses were used to identify the independent clinical factors associated with latency period after PPROM and assess the predictive accuracy for SLP.
98 and 92 pregnant women had short and long latency period, respectively. Prolonged latency significantly increased the occurrence of chorioamnionitis. Neonatal outcomes were not affected by latency duration after PPROM. Binary regression analysis revealed that higher gestational age (GA) at PPROM ( = 0.038), presence of uterine contractions ( < 0.001), Bishop score > 4 ( = 0.030), serum procalcitonin levels ≥0.05 ng/mL upon admission, and absence of use of tocolytic agents ( < 0.001) were significant independent predictors of a SLP. A predictive model developed using these predictors had an area under the curve (AUC) of 0.838, and the presence of uterine contractions alone had an AUC of = 0.711.
Uterine contraction was the most important prognosticator for a SLP. A latency period of >24 h was associated with chorioamnionitis, but adverse neonatal outcomes were not observed.
关于双胎妊娠合并胎膜早破（PPROM）的短潜伏期（SLP）的文献较少。因此，本研究的目的是确定双胎妊娠合并PPROM中与SLP相关的临床因素和围产期结局，并建立一个预测模型来识别SLP。
纳入24⁰/₇至33⁶/₇周的双胎妊娠合并PPROM患者，并进行回顾性分析。根据PPROM后的潜伏期将患者分为两组：第1组≤24小时（定义为SLP）和第2组>24小时（定义为长潜伏期，LLP），比较两组的临床因素和围产期结局。采用二元逻辑回归和受试者工作特征曲线分析来确定与PPROM后潜伏期相关的独立临床因素，并评估SLP的预测准确性。
分别有98例和92例孕妇有短潜伏期和长潜伏期。潜伏期延长显著增加绒毛膜羊膜炎的发生率。PPROM后的潜伏期持续时间不影响新生儿结局。二元回归分析显示，PPROM时较高的孕周（GA）（P = 0.038）、子宫收缩的存在（P < 0.001）、Bishop评分>4（P = 0.030）、入院时血清降钙素原水平≥0.05 ng/mL以及未使用宫缩抑制剂（P < 0.001）是SLP的显著独立预测因素。使用这些预测因素建立的预测模型的曲线下面积（AUC）为0.838，仅子宫收缩存在时的AUC为P = 0.711。
子宫收缩是SLP最重要的预后因素。潜伏期>24小时与绒毛膜羊膜炎相关，但未观察到不良新生儿结局。
