Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kruschitz, M.
Neonatal and long-term neurodevelopmental outcome after extreme preterm premature rupture of membranes (pPROM)
[ Diplomarbeit ] Graz Medical University; 2012. pp. 88
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Csapo Bence Daniel
- Klaritsch Philipp
- Altmetrics:
- Abstract:
- Abstract:Preterm premature Rupture of the membranes is classified as one of the main reasons of extreme preterm birth. This complication of pregnancy is steadily increasing in the western world. It was the aim of this study, to consider the short- and long-term impacts that preterm premature rupture of the membranes between 18+0 to 27+6 weeks of gestation has on infants and to analyse and examine the cognitive and locomotor development of the affected infants at the age of 2 years corrected for prematurity. Materials and Methods:A retrospective analysis composed of obstetric and neonatal data from the clinical Databases PIA and Medocs was carried out at the Division of Obstetrics and Maternal Fetal Medicine from cases in the years 2003 through 2010. 107 women with pPROM within 18+0 to 27+6 weeks of gestation were included to the study. 82 infants survived until discharge from hospital. The examination of the developmental outcome of 46 children, of a total of 82 infants who survived until discharge from hospital, took place at the age of 2 years corrected for prematurity at the Neurodevelopmental outpatient clinic, Medical University Graz with the help of the Bayley Scales of Infant Development. Results:The mean latency between preterm premature rupture of the membranes and delivery was 13 days. The overall survival rate was 70% (82 of 117). 17 fetuses died in utero and another 18 preterm infants died within a maximum of 31 days post partum. The higher the gestational age at delivery and birth weight the lower was the rate of complications. The complications that the infants developed are: Bronchopulmonary dysplasia in 13 cases, different grades of intraventricular haemorrhage in 30 cases, different grades of periventricular leukomalacia in 7 cases, posthaemorrhagic hydrocephalus in 4 cases, microccephalus in 2 cases, ileus in 4 cases, necrotising enterocolitis in 2 cases, perforation of the bowels in 6 cases, sepsis in 43 cases, retinopathy of prematurity in 8 cases. 60% of the children that could be tested with 2 years showed a normal mental and locomotor development. Conclusion:Gestational age at birth, birth weight and acute complications such as sepsis, or intraventricular haemorrhage have prognostic importance for preterm infants, as infants with higher gestational age and birth weight as well as the absence of complications showed a better outcome. 60% of the infants showed a normal cognitive and locomotor development at the age of 2 years corrected for prematurity. It is possible that, the 2-year follow-up was squewed due to the high dropout rate (no infants with a birth weight above 1500g visited the Neurodevelopmental outpatient clinic and some of the infants will not be tested until summer 2012)