The utility of umbilical artery doppler in preterm premature rupture of membranes

Preterm premature rupture of membranes (PPROM) is a common complication of pregnancy and occurs in up to a third of all preterm births. Currently, there is no way to predict how long a patient will remain pregnant after rupture of membranes (latency period) nor are we able to predict which patients will develop intrauterine infection (chorioamnionitis). Previous studies have shown some interest in the use of umbilical artery Doppler to predict latency as well as chorioamnionitis. This study aims to evaluate the ability of umbilical artery Doppler to predict latency period and correlate with the occurrence of chorioamnionitis. A retrospective chart review of patients having an ultrasound with the indication PPROM was performed. Three different Doppler-derived measures (S/D, PI, and RI) performed at time of PPROM were assessed. Continuous Doppler data were categorized as normal or abnormal using standardized cut-off points. After review of 964 patients from the ultrasound database, 320 patients were included for analysis. The average length of latency was 10.5 days (median = 6 days). Admission S/D (systolic/diastolic) and RI (resistive index) was not predictive of latency when controlling for cervical dilation, IRR 0.90, 95% CI = 0.56-1.43, ρ = .64 and IRR 0.95, 95% CI = 0.62-1.45, ρ = .82 respectively. Delivery S/D and RI Dopplers were not predictive of latency when controlling for cervical dilation, IRR 0.72, 95% CI = 0.35-1.49, ρ = .38 and IRR 0.71, 95% CI = 0.38-1.30, ρ = x² [(1, N=284) = 1.17, ρ = .28] and x² [(1, N=282) = 1.50, ρ = .22] respectively. Delivery S/D and RI Dopplers were also not predictive of chorioamnionitis, S/D x²[(1, N=182) = 0.02, ρ = .90] and x²[(1, N=180) = 2.33, ρ = .13], respectively. Doppler does not appear to correlate with length of latency or the development of chorioamnionitis. However, there were few numbers of abnormal Doppler values, which may have resulted in under-powering this study.

Name thesis:degree_name

M.S.

Level thesis:degree_level

Masters

Discipline thesis:degree_discipline

Bioinformatics (UMKC)

Grantor

University of Missouri--Kansas City

Year dc:date.issued

2013

Author dc:creator

• Heitmann, Erica Renee

Advisor dc:contributor.advisor

• Gerkovich, Mary M., 1950-

Handle dc:identifier.uri

http://hdl.handle.net/10355/39127

OAI identifier oai:identifier

oai:mospace.umsystem.edu:10355/39127