Transvaginal Cervical Length To Predict Delivery Latency in Preterm Premature Rupture of Membranes

Abstract

Abstract Purpose: To investigate the association between transvaginal cervical length (TVCL) and delivery latency in pregnancies with preterm premature rupture of membranes (PPROM). Methods: A prospective study was conducted with 72 cases with PPROM between 24 and 34 weeks of gestation. Maternal characteristics, TVCL, the time between diagnosis of PPROM and delivery, and obstetric outcomes were documented. Multiple logistic regression was used to evaluate the independent prediction of significant parameters for delivery within seven days. Sensitivity, specificity, and predictive values were calculated for the combination of TVCL, presence of a cervical funneling, and maternal body mass index (BMI) to predict delivery within seven days. Results: 44% of the 72 PPROM cases were delivered within the first seven days after PPROM. Cervical funneling and short TVCL were associated with latency <7 day (p= 0.001 and p=0.000). In logistic regression analysis, gestational week of PPROM and TVCL were found to be the parameters affecting the delivery risk with a latency ≤7 days. (OR =1.402, p=0.039; OR=0.46, p=0.045 respectively). The combination of <25 mm TVCL and the presence of cervical funneling had a sensitivity of 38% and a specificity of 97.5% in predicting latency ≤7 days. In BMI>30 group, the PPV reached 100% in predicting latency ≤7 days with 18% sensitivity and 100% specificity. Conclusion: The combination of cervical funneling, TVCL <25 mm, and maternal obesity can predict delivery within seven days of PPROM. These findings may be helpful in counseling and optimizing maternal and neonatal care in women with PPROM.